You are here

Utility of 3-dimensional image reconstruction in the diagnosis of small-bowel masses in capsule endoscopy (with video).

Printer-friendly versionPrinter-friendly version
Rondonotti E, Koulaouzidis A, Karargyris A, Giannakou A, Fini L, Soncini M, Pennazio M, Douglas S, Shams A, Lachlan N, Zahid A, Mandelli G, Girelli C
Gastrointest Endosc. 2014 Oct;80(4):642-51. doi: 10.1016/j.gie.2014.04.057. Epub 2014 Jul 3.
Abstract: 

BACKGROUND

In small-bowel capsule endoscopy (SBCE), differentiating masses (ie, lesions of higher probability for neoplasia) requiring more aggressive intervention from bulges (essentially, false-positive findings) is a challenging task; recently, software that enables 3-dimensional (3D) reconstruction has become available.

OBJECTIVE

To evaluate whether "coupling" 3D reconstructed video clips with the standard 2-dimensional (s2D) counterparts helps in distinguishing masses from bulges.

DESIGN

Three expert and 3 novice SBCE readers, blind to others and in a random order, reviewed the s2D video clips and subsequently the s2D clips coupled with their 3D reconstruction (2D+3D).

SETTING

Multicenter study in 3 community hospitals in Italy and a university hospital in Scotland.

PATIENTS

Thirty-two deidentified 5-minute video clips, containing mucosal bulging (19) or masses (13).

INTERVENTION

3D reconstruction of s2D SBCE video clips.

MAIN OUTCOME MEASURE

Differentiation of masses from bulges with s2D and 2D+3D video clips, estimated by the area under the receiver operating characteristic curve (AUC); interobserver agreement.

RESULTS

AUC for experts and novices for s2D video clips was .74 and .5, respectively (P = .0053). AUC for experts and novices with 2D+3D was .70 (compared with s2D: P = .245) and .57 (compared s2D: P = .049), respectively. AUC for experts and novices with 2D+3D was similar (P = .1846). The interobserver agreement was good for both experts and novices with the s2D (k = .71 and .54, respectively) and the 2D+3D video clips (k = .58 in both groups).

LIMITATIONS

Few, short video clips; fixed angle of 3D reconstruction.

CONCLUSIONS

The adjunction of a 3D reconstruction to the s2D video reading platform does not improve the performance of expert SBCE readers, although it significantly increases the performance of novices in distinguishing masses from bulging.

Copyright © 2014 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

Rondonotti E, Koulaouzidis A, Karargyris A, Giannakou A, Fini L, Soncini M, Pennazio M, Douglas S, Shams A, Lachlan N, Zahid A, Mandelli G, Girelli C. Utility of 3-dimensional image reconstruction in the diagnosis of small-bowel masses in capsule endoscopy (with video). Gastrointest Endosc. 2014 Oct;80(4):642-51. doi: 10.1016/j.gie.2014.04.057. Epub 2014 Jul 3.