Acceptability, Accuracy, and Safety of Disposable Transnasal Capsule Endoscopy for Barrett's Esophagus Screening

Sarmed S. Sami, Prasad G. Iyer, Prachi Pophali, Magnus Halland, Massimiliano di Pietro, Jacobo Ortiz-Fernandez-Sordo, Jonathan R. White, Michele Johnson, Indra Neil Guha, Rebecca C. Fitzgerald, Krish Ragunath

Research output: Contribution to journalArticlepeer-review

14 Scopus citations

Abstract

Background & Aims: Screening for Barrett's esophagus (BE) with conventional esophagogastroduodenoscopy (C-EGD) is expensive. We assessed the performance of a clinic-based, single use transnasal capsule endoscope (EG Scan II) for the detection of BE, compared to C-EGD as the reference standard. Methods: We performed a prospective multicenter cohort study of patients with and without BE recruited from 3 referral centers (1 in the United States and 2 in the United Kingdom). Of 200 consenting participants, 178 (89%) completed both procedures (11% failed EG Scan due to the inability to intubate the nasopharynx). The mean age of participants was 57.9 years and 67% were male. The prevalence of BE was 53%. All subjects underwent the 2 procedures on the same day, performed by blinded endoscopists. Patients completed preference and validated tolerability (10-point visual analogue scale [VAS]) questionnaires within 14 days of the procedures. Results: A higher proportion of patients preferred the EG Scan (54.2%) vs the C-EGD (16.7%) (P <.001) and the EG Scan had a higher VAS score (7.2) vs the C-EGD (6.4) (P =.0004). No serious adverse events occurred. The EG Scan identified any length BE with a sensitivity value of 0.90 (95% CI, 0.83–0.96) and a specificity value of 0.91 (95% CI, 0.82–0.96). The EG Scan identified long segment BE with a sensitivity value of 0.95 and short segment BE with a sensitivity values of 0.87. Conclusions: In a prospective study, we found the EG Scan to be safe and to detect BE with higher than 90% sensitivity and specificity. A higher proportion of patients preferred the EG Scan to C-EGD. This device might be used as a clinic-based tool to screen populations at risk for BE. ISRCTN registry identifier: 70595405; ClinicalTrials.gov no: NCT02066233.

Original languageEnglish (US)
Pages (from-to)638-646.e1
JournalClinical Gastroenterology and Hepatology
Volume17
Issue number4
DOIs
StatePublished - Mar 2019

Keywords

  • Esophageal Adenocarcinoma
  • Imaging
  • Office
  • Portable
  • Reflux

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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