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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)

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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:

 

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