Accuracy of capsule colonoscopy and computed tomographic colonography in individuals with positive results from the fecal occult blood test

Emanuele Rondonotti, Claudia Borghi, Giovanna Mandelli, Franco Radaelli, Silvia Paggi, Arnaldo Amato, Gianni Imperiali, Natalia Terreni, Nicoletta Lenoci, Vittorio Terruzzi, Alessandra Baccarin, Alberto Martegani, Giancarlo Spinzi

Research output: Contribution to journalArticlepeer-review

Abstract

Background & Aims: Computed tomographic colonography (CTC) is a reliable option for screening subjects who are unable or unwilling to undergo optical colonoscopy (OC). A colon capsule (PillCam Colon2 [CC2]; GivenImaging Ltd., Yokneam, Israel) has shown promising results in detecting polyps larger than 6 mm. We compared the accuracy of CC2 and CTC in identifying individuals with at least 1 polyp greater than 6 mm and subjects' attitude toward the procedures. Methods: Fifty individuals (mean age, 59.2 ± 5.8 y; 58% male) with positive results from the immunochemical fecal occult blood test (iFOBT-positive) underwent CC2, CTC, and OC. The unblinded colonoscopy, integrating OC, CTC, and CC2 results, was used as the reference standard. In a per-patient analysis, the accuracy of CC2 and CTC were assessed for individuals with at least 1 polyp 6 mm or larger. Individuals were asked to choose which procedure they would be willing to repeat between CTC and CC2. Results: The combination of OC, CTC, and CC2 identified 16 cases with at least 1 polyp 6 mm or larger (reference standard). CTC identified the polyps with 88.2% sensitivity, 84.8% specificity, a 3.0 positive likelihood ratio, and a 0.07 negative likelihood ratio. CC2 identified the polyps with 88.2% sensitivity, 87.8% specificity, a 3.75 positive likelihood ratio, and a 0.06 negative likelihood ratio. Thirty-nine subjects (78%) said they preferred CC2 to CTC. Conclusions: CC2 and CTC detect polyps 6 mm and larger with high levels of accuracy; these techniques are effective in selecting iFOBT-positive individuals who do not need to be referred for colonoscopy. CC2 seems to be better tolerated than CTC, and could be a reliable alternative to CTC for iFOBT-positive individuals who are unable or unwilling to undergo OC. ClinicalTrials.gov number: NCT01744509.

Original languageEnglish
Pages (from-to)1303-1310
Number of pages8
JournalClinical Gastroenterology and Hepatology
Volume12
Issue number8
DOIs
Publication statusPublished - 2014

Keywords

  • Capsule colonoscopy
  • Colon cancer
  • Computer tomographic colonography
  • Early detection
  • Optical colonoscopy

ASJC Scopus subject areas

  • Gastroenterology
  • Hepatology
  • Medicine(all)

Fingerprint Dive into the research topics of 'Accuracy of capsule colonoscopy and computed tomographic colonography in individuals with positive results from the fecal occult blood test'. Together they form a unique fingerprint.

Cite this