A rapid and accurate method to detect active small bowel gastrointestinal bleeding on video capsule endoscopy

Dig Dis Sci. 2014 Oct;59(10):2503-7. doi: 10.1007/s10620-014-3327-8. Epub 2014 Aug 22.

Abstract

Background: Video capsule endoscopy (VCE) is indicated to evaluate for suspected small bowel bleeding, but "standard view" (SV) evaluation is time-consuming. Rapid Reader 6.0 software (Given Imaging, Duluth GA) contains two computer algorithmic systems: (1) "Quickview" (QV) which automatically skips similar images and (2) a pixel analysis program that identifies suspected blood (SBI). Combining the two modalities (QV + SBI) may provide a faster modality to assess for active small bowel bleeding.

Aims: This study was designed to assess the accuracy of QV + SBI for small bowel bleeding compared to SV findings.

Methods: This is a retrospective, case-control study at a single tertiary care referral hospital including all patients with VCE performed for suspected small bowel bleeding from 4/2007 to 3/2011. All studies were previously read using SV by one of two experienced faculty (CS, DR). The primary outcome was diagnostic accuracy of QV + SBI in assessing for active small bowel bleeding compared to SV.

Results: A total of 116 VCE were included, 28 with active small bowel bleeding identified by original SV. Using QV + SBI, all 28 VCEs with active small bowel bleeding were identified. The sensitivity of QV + SBI to detect active bleeding was 100%, while the specificity was 93-94%. The mean time to identify landmarks and read the entire study was 3 min 20 s.

Conclusions: The QV + SBI reading format of VCE is an efficient, highly sensitive modality to assess for potential small bowel bleeding.

MeSH terms

  • Capsule Endoscopy / methods*
  • Gastrointestinal Hemorrhage / diagnosis*
  • Humans
  • Intestine, Small / pathology*
  • Retrospective Studies