CT-enterography may identify small bowel tumors not detected by capsule endoscopy: Eight years experience at Mayo Clinic Rochester

Fayaz A. Hakim, Jeffrey A. Alexander, James E. Huprich, Madhusudan Grover, Felicity T Enders

Research output: Contribution to journalArticle

78 Citations (Scopus)

Abstract

Background: Capsule endoscopy (CE) is widely accepted as the preferred diagnostic test in the evaluation of small bowel diseases. However, small bowel tumors (SBT) are sometimes missed by CE. Preliminary studies suggest that CT-enterography (CTE) may play a role in detecting SBT. Aims: The purpose of this study was to compare the performance of CE and CTE in detecting SBT Methods: This was a single center, retrospective study. Patients treated at the Mayo Clinic Rochester between January 2000 and December 2008 with a discharge diagnosis of SBT and negative initial esophagogastroduodenoscopy (EGD) and colonoscopy were identified through a search of the electronic medical records. Among 103 identified patients, 41 had undergone CE, CTE or both, and comprised our study group. The exact binomial sensitivity of CE and CTE in detecting SBT was calculated. Demographic characteristics, clinical presentation, results of diagnostic tests, and tumor characteristics were recorded for each patient. Results: CTE and CE detected 38/41 (sensitivity 92.7%; 95% CI 80.1-98.5) and 8/27 (sensitivity 29.6%; 95% CI 13.8-50.2) of the SBT identified at Mayo Clinic Rochester, respectively. Seventeen patients had both CTE and CE. In this subgroup of patients, CTE detected SBT in 16/17 (sensitivity 94.1; 95% CI 72.7-99.9) and CE in 6/17 (sensitivity 35.3%; 95% CI 13.3-59). The matched paired difference in the sensitivity of two techniques in detecting SBT was statistically significant (P = 0.004). Conclusion: CTE may identify SBT not diagnosed by CE.

Original languageEnglish (US)
Pages (from-to)2914-2919
Number of pages6
JournalDigestive Diseases and Sciences
Volume56
Issue number10
DOIs
StatePublished - Oct 2011

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Capsule Endoscopy
Neoplasms
Routine Diagnostic Tests
Digestive System Endoscopy
Electronic Health Records
Colonoscopy
Retrospective Studies
Demography

Keywords

  • Capsule endoscopy
  • CT-enterography
  • Small bowel tumors

ASJC Scopus subject areas

  • Gastroenterology
  • Physiology

Cite this

CT-enterography may identify small bowel tumors not detected by capsule endoscopy : Eight years experience at Mayo Clinic Rochester. / Hakim, Fayaz A.; Alexander, Jeffrey A.; Huprich, James E.; Grover, Madhusudan; Enders, Felicity T.

In: Digestive Diseases and Sciences, Vol. 56, No. 10, 10.2011, p. 2914-2919.

Research output: Contribution to journalArticle

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abstract = "Background: Capsule endoscopy (CE) is widely accepted as the preferred diagnostic test in the evaluation of small bowel diseases. However, small bowel tumors (SBT) are sometimes missed by CE. Preliminary studies suggest that CT-enterography (CTE) may play a role in detecting SBT. Aims: The purpose of this study was to compare the performance of CE and CTE in detecting SBT Methods: This was a single center, retrospective study. Patients treated at the Mayo Clinic Rochester between January 2000 and December 2008 with a discharge diagnosis of SBT and negative initial esophagogastroduodenoscopy (EGD) and colonoscopy were identified through a search of the electronic medical records. Among 103 identified patients, 41 had undergone CE, CTE or both, and comprised our study group. The exact binomial sensitivity of CE and CTE in detecting SBT was calculated. Demographic characteristics, clinical presentation, results of diagnostic tests, and tumor characteristics were recorded for each patient. Results: CTE and CE detected 38/41 (sensitivity 92.7{\%}; 95{\%} CI 80.1-98.5) and 8/27 (sensitivity 29.6{\%}; 95{\%} CI 13.8-50.2) of the SBT identified at Mayo Clinic Rochester, respectively. Seventeen patients had both CTE and CE. In this subgroup of patients, CTE detected SBT in 16/17 (sensitivity 94.1; 95{\%} CI 72.7-99.9) and CE in 6/17 (sensitivity 35.3{\%}; 95{\%} CI 13.3-59). The matched paired difference in the sensitivity of two techniques in detecting SBT was statistically significant (P = 0.004). Conclusion: CTE may identify SBT not diagnosed by CE.",
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