Usefulness of panoramic 344°-viewing in Crohn's disease capsule endoscopy: a proof of concept pilot study with the novel PillCam™ Crohn's system

• Published in: BMC gastroenterology 2020-04, Vol.20 (1), p.97-97, Article 97
• Main Authors: Tontini, Gian Eugenio, Rizzello, Fernando, Cavallaro, Flaminia, Bonitta, Gianluca, Gelli, Dania, Pastorelli, Luca, Salice, Marco, Vecchi, Maurizio, Gionchetti, Paolo, Calabrese, Carlo
• Format: Article
• Language: English
• Subjects: Adult; Cameras; Capsule Endoscopes; Capsule endoscopy; Capsule Endoscopy - instrumentation; Capsule Endoscopy - methods; Clinical medicine; Crohn Disease - diagnostic imaging; Crohn's disease; Diagnosis; Edema; Endoscopy; Enteroscopy; Female; Follow-Up Studies; Gastroenterology; Humans; Inflammatory bowel disease; Inflammatory bowel diseases; Lesions; Male; Middle Aged; Optics; Pan-intestinal endoscopy; Patients; PillCam™ Crohn’s system; Pilot Projects; Proof of Concept Study; Sensitivity and Specificity; Small intestine; Ulcers
• ISSN: 1471-230X; 1471-230X
• DOI: 10.1186/s12876-020-01231-0

A new capsule endoscopy (CE) system featuring two advanced optics for 344°-viewing and a prolonged operative time has been recently developed for Crohn's disease (CD) patients. Hence, we evaluated, for the first time, the performance of this novel CE and the add-on value of the 344°-viewing in a multi-center real-life setting. Consecutive patients with suspected or established CD received the PillCam™ Crohn's System as supplementary diagnostic work-up focused on the small-bowel between June 2017 and June 2018. Technical and clinical data, including the panenteric CE diagnostic yield, the Lewis score and the impact of small-bowel findings on clinical management during a 6-months follow-up (new diagnosis, staging or treatment upgrade) were collected, thereby evaluating the added value of the 344° panoramic-view (lesions detected by camera A and B) over the standard 172°-view (lesions detected by one camera only). Among 41 patients (aged 43 ± 20 years), 73% underwent CE for suspected CD and 27% for established CD. The rate of complete enteroscopy was 90%. No technical failure or retention occurred. Compared to the standard 172° view, the panoramic 344°-view revealed a greater number of patients with a relevant lesion (56.1% vs. 39.0%; P = 0.023), resulting in higher Lewis score (222,8 vs. 185.7; P = 0.031), and improved clinical management (48.8% vs. 31.7%, P = 0.023). The panoramic 344°-view increases small-bowel CE accuracy, thereby improving the clinical management of CD patients with mild small-bowel active disease. This system should be regarded as a new standard for both small-bowel diagnosis and monitoring in inflammatory bowel diseases.