Capsule endoscopy, the "camera pill" introduced several years ago, continues to show promise in the diagnosis of small-bowel disease. One caveat, however, is its inability to localize the abnormalities. CT may be the perfect complement to pair it up with, according to researchers at the Mayo Clinic in Scottsdale, AZ.
Investigators retrospectively compared capsule endoscopy (CE), barium, and CT findings from the first 52 patients who underwent examination from September 2001 through April 2002. They confirmed that CE detects more bowel disease than barium or CT in findings published in the January issue of Radiology.
CE showed 55% of positive findings compared with 3% for barium. CE also showed 63% of small-bowel findings compared with 21% found with CT. Investigators also confirmed that the most common CE finding, angioectasia, was detected by neither barium nor CT.
The technique has one major shortcoming: Physicians cannot control the pill once it is ingested, which limits its ability to localize a finding or determine its clinical importance. Combining CE with CT may unleash its full potential, researchers said.
As the camera tumbles through the intestine, imagers can't tell exactly where a mass is located, said principal investigator Dr. Amy K. Hara, a diagnostic radiologist at the Arizona clinic. CT provides a very good global view of the body, however, and it can help localize the lesions found with CE.
The technique could benefit a number of patients, mostly those with Crohn's disease, tumors, ulcers, vascular malformations, and other small-bowel abnormalities. It provides a more comfortable alternative to barium, with more coverage than standard endoscopy, which reaches only the upper and very lower portion of the small intestine.
"The information we are gaining from CE will allow us to improve our use of CT for better diagnoses and determine when to pair the two technologies," Hara said.
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