Download PDF
Endoscopy 2012; 44(11): 1012-1020
DOI: 10.1055/s-0032-1310158
Original article
© Georg Thieme Verlag KG Stuttgart · New York

A randomized head-to-head study of small-bowel imaging comparing MiroCam and EndoCapsule

W. Dolak
  Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Austria
,
S. Kulnigg-Dabsch
  Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Austria
,
R. Evstatiev
  Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Austria
,
C. Gasche
  Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Austria
,
M. Trauner
  Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Austria
,
A. Püspök
  Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Austria
› Author Affiliations
Further Information

Publication History

submitted 11 December 2011

accepted after revision 15 June 2012

Publication Date:
28 August 2012 (online)

Also available at
    Permissions and Reprints

Background and study aims: The MiroCam is a new video capsule device offering a higher frame rate and a longer battery life-expectancy. We aimed to quantify its clinical impact and performed a randomized head-to-head comparison with the EndoCapsule device with respect to the rate of complete small-bowel examinations, diagnostic yield in the small bowel, and capsule transit time.

Patients and methods: Patients referred for video capsule endoscopy because of obscure gastrointestinal bleeding, chronic diarrhea, and anemia of unknown origin were randomly assigned to swallow either the MiroCam first, followed by the EndoCapsule 2 hours later, or vice versa. All videos were analyzed by two independent investigators.

Results: A total of 50 patients (median age 61, range 21 – 84) were included. Complete small-bowel examination was achieved in 48 /50 patients using the MiroCam and 45 /50 using the EndoCapsule (96 % vs. 90 %, odds ratio [OR] 2.67, 95 % confidence interval [CI] 0.49 – 14.45; P = 0.38). There was diagnostic yield in the small bowel for 25 /50 patients using the MiroCam and 24 /50 using the EndoCapsule (50 % vs. 48 %, OR 1.08, 95 %CI 0.49 – 2.37; P > 0.99). However, the findings were concordant in 68 % only (kappa = 0.50). The combined diagnostic yield was 58 %. Even solitary findings had a relevant clinical impact during a 6-month follow-up.

Conclusion: In this direct comparison the MiroCam and EndoCapsule devices were not statistically different with regard to their rates of complete small-bowel examinations or diagnostic yield. Their moderate concordance, mainly caused by missed pathological findings, which affected both devices, needs consideration in clinical practice.

Table e3 is available online:

 

  • References

  • 1 Iddan G, Meron G, Glukhovsky A et al. Wireless capsule endoscopy. Nature 2000; 405: 417
    PubMedGoogle Scholar
  • 2 Delvaux M, Gay G. International conference on capsule and double-balloon endoscopy (ICCD). Paris, 27–28 August 2010. Endoscopy 2011; 43: 533-539
    Article in Thieme ConnectPubMedGoogle Scholar
  • 3 Carey EJ, Leighton JA, Heigh RI et al. A single-center experience of 260 consecutive patients undergoing capsule endoscopy for obscure gastrointestinal bleeding. Am J Gastroenterol 2007; 102: 89-95
    CrossrefPubMedGoogle Scholar
  • 4 Doherty GA, Moss AC, Cheifetz AS. Capsule endoscopy for small-bowel evaluation in Crohn's disease. Gastrointest Endosc 2011; 74: 167-175
    CrossrefPubMedGoogle Scholar
  • 5 Apostolopoulos P, Liatsos C, Gralnek IM et al. The role of wireless capsule endoscopy in investigating unexplained iron deficiency anemia after negative endoscopic evaluation of the upper and lower gastrointestinal tract. Endoscopy 2006; 38: 1127-1132
    Article in Thieme ConnectPubMedGoogle Scholar
  • 6 Burke CA, Santisi J, Church J et al. The utility of capsule endoscopy small-bowel surveillance in patients with polyposis. Am J Gastroenterol 2005; 100: 1498-1502
    CrossrefPubMedGoogle Scholar
  • 7 Rondonotti E, Spada C, Cave D et al. Video capsule enteroscopy in the diagnosis of celiac disease: a multicenter study. Am J Gastroenterol 2007; 102: 1624-1631
    CrossrefPubMedGoogle Scholar
  • 8 de' Angelis GL, Fornaroli F, de' Angelis N et al. Wireless capsule endoscopy for pediatric small-bowel diseases. Am J Gastroenterol 2007; 102: 1749-1757
    CrossrefPubMedGoogle Scholar
  • 9 Sturniolo GC, Di Leo V, Vettorato MG et al. Small bowel exploration by wireless capsule endoscopy: results from 314 procedures. Am J Med 2006; 119: 341-347
    CrossrefPubMedGoogle Scholar
  • 10 Westerhof J, Weersma RK, Koornstra JJ. Risk factors for incomplete small-bowel capsule endoscopy. Gastrointest Endosc 2009; 69: 74-80
    CrossrefPubMedGoogle Scholar
  • 11 Ben-Soussan E, Savoye G, Antonietti M et al. Factors that affect gastric passage of video capsule. Gastrointest Endosc 2005; 62: 785-790
    CrossrefPubMedGoogle Scholar
  • 12 Triantafyllou K, Kalantzis C, Papadopoulos AA et al. Video-capsule endoscopy gastric and small bowel transit time and completeness of the examination in patients with diabetes mellitus. Dig Liver Dis 2007; 39: 575-580
    CrossrefPubMedGoogle Scholar
  • 13 Bang S, Park JY, Jeong S et al. First clinical trial of the ‘MiRo’ capsule endoscope by using a novel transmission technology: electric-field propagation. Gastrointest Endosc 2009; 69: 253-259
    CrossrefPubMedGoogle Scholar
  • 14 Kim HM, Kim YJ, Kim HJ et al. A pilot study of sequential capsule endoscopy using MiroCam and PillCam SB devices with different transmission technologies. Gut Liver 2010; 4: 192-200
    CrossrefPubMedGoogle Scholar
  • 15 Pioche M, Gaudin JL, Filoche B et al. Prospective, randomized comparison of two small-bowel capsule endoscopy systems in patients with obscure GI bleeding. Gastrointest Endosc 2011; 73: 1181-1188
    CrossrefPubMedGoogle Scholar
  • 16 Gheorghe C, Iacob R, Bancila I. Olympus capsule endoscopy for small bowel examination. J Gastrointestin Liver Dis 2007; 16: 309-313
    PubMedGoogle Scholar
  • 17 Korman LY, Delvaux M, Gay G et al. Capsule endoscopy structured terminology (CEST): proposal of a standardized and structured terminology for reporting capsule endoscopy procedures. Endoscopy 2005; 37: 951-959
    Article in Thieme ConnectPubMedGoogle Scholar
  • 18 Bar-Meir S. Review article: capsule endoscopy – are all small intestinal lesions Crohn's disease?. Aliment Pharmacol Ther 2006; 24: 19-21
    PubMedGoogle Scholar
  • 19 Ogata H, Kumai K, Imaeda H et al. Clinical impact of a newly developed capsule endoscope: usefulness of a real-time image viewer for gastric transit abnormality. J Gastroenterol 2008; 43: 186-192
    CrossrefPubMedGoogle Scholar
  • 20 Caddy G, Moran L, Chong A et al. The effect of erythromycin on video capsule endoscopy intestinal-transit time. Gastrointest Endosc 2006; 63: 262-266
    CrossrefPubMedGoogle Scholar
  • 21 Niv E, Bogner I, Barkey O et al. Effect of erythromycin on image quality and transit time of capsule endoscopy: A two-center study. World J Gastroenterol 2008; 14: 2561-2565
    CrossrefPubMedGoogle Scholar
  • 22 Buscaglia JM, Kapoor S, Clarke JO et al. Enhanced diagnostic yield with prolonged small bowel transit time during capsule endoscopy. Int J Med Sci 2008; 5: 303-308
    PubMedGoogle Scholar
  • 23 Carpi F, Pappone C. Magnetic robotic manoeuvring of gastrointestinal video capsules: preliminary phantom tests. Biomed Pharmacother 2008; 62: 546-549
    CrossrefPubMedGoogle Scholar
  • 24 Swain P, Toor A, Volke F et al. Remote magnetic manipulation of a wireless capsule endoscope in the esophagus and stomach of humans. Gastrointest Endosc 2010; 71: 1290-1293
    CrossrefPubMedGoogle Scholar
  • 25 Hartmann D, Eickhoff A, Damian U et al. Diagnosis of small-bowel pathology using paired capsule endoscopy with two different devices: a randomized study. Endoscopy 2007; 39: 1041-1045
    Article in Thieme ConnectPubMedGoogle Scholar
  • 26 Cave DR, Fleischer DE, Leighton JA et al. A multicenter randomized comparison of the Endocapsule and the Pillcam SB. Gastrointest Endosc 2008; 68: 487-494
    CrossrefPubMedGoogle Scholar
  • 27 Lecleire S, Iwanicki-Caron I, Di-Fiore A. Yield and impact of emergency capsule enteroscopy in severe obscure-overt gastrointestinal bleeding. Endoscopy 2012; 44: 337-342
    Article in Thieme ConnectPubMedGoogle Scholar
  • 28 Esaki M, Matsumoto T, Yada S et al. Factors associated with the clinical impact of capsule endoscopy in patients with overt obscure gastrointestinal bleeding. Dig Dis Sci 2010; 55: 2294-2301
    CrossrefPubMedGoogle Scholar
  • 29 Goenka MK, Majumder S, Kumar S et al. Single center experience of capsule endoscopy in patients with obscure gastrointestinal bleeding. World J Gastroenterol 2011; 17: 774-778
    CrossrefPubMedGoogle Scholar
  • 30 Dolak W, Kulnigg-Dabsch S, Puespoek A. Capsule comparison study Vienna: IntroMedic's MiroCam has a significantly higher diagnostic yield than Olympus' Enteropro EndoCapsule at an interim analysis of 30 patients. Gastrointest Endosc 2011; 73: AB123
    PubMedGoogle Scholar