Capsule Endoscopy for Crohn’s Disease: Current Status of Diagnosis and Management

Table 1

Comparison of video capsule endoscopy with small bowel barium radiography: diagnostic yield or performance for suspected or established Crohn’s disease.

Study	Design	Number of cases	Tests	Definition/description for positive findings	Diagnostic yield	Sensitivity/specificity
Eliakim et al. (2004) [12]	Prospective	35	VCE	Ulcers/erosions, erythema, aphthae, and nodular lymphoid hyperplasia	77%	NA
			SBFT	Wall thickening, nodularity in terminal ileum, and ulcers	23%	NA
Buchman et al. (2004) [11]	Prospective	30	VCE	Grade 0: normal; Grade 1: erythema, isolated villi loss; Grade 2: erosion, no ulcer; Grade 3: ulcers, spontaneous bleeding, and/or stricture	70%	NA
			SBFT	Grade 0: normal; Grade 1: minimal nodularity, ulcerations, normal luminal diameter, and <5 cm involvement; Grade 2: more extensive ulcers, minimal luminal narrowing, and 5–10 cm involvement; Grade 3: fistula, skip areas, extensive ulcerations, and >10 cm involvement	67%	NA
Dubcenco et al. (2005) [10]	Prospective	39	VCE	Presence of 3 ulcerations	67%	NA
			SBFT	Active inflammatory or fistulizing/perforating subtypes	21%	NA
Hara et al. (2006) [21]	Prospective	17	VCE	Erosions, ulcers, or strictures	71%	NA
			SBFT	Abnormal nodularity, loss of normal mucosal folds, linear ulcers, strictures, or fistulas	24%	NA
Efthymiou et al. (2009) [16]	Prospective	47 in total; 29 established CD; 26 suspected CD	VCE	Diffuse erythema, erosions, >3 aphthous ulcers, ulcers of different shape (serpiginous, linear, oval, and coalescing), and strictures	67%	NA
			EC	Fold thickening, aphthous ulceration, nodular appearances, ulcers at the mesenteric border, cobblestone appearance, fixed strictures, and fistulae	36%	NA
Solem et al. (2008) [23]	Prospective	27	VCE	NA^(1)	NA	83%/53%
			EC	NA^(1)	NA	65%/94%
Marmo et al. (2005) [14]	Prospective	31	VCE ()	Diffuse small bowel lesions, multiple (>3) erosions, or ulcers that were serpiginous, deep fissuring, coalescing, linear, or nodular	71% (22/31)	NA
			EC ()	Fold thickening, aphthous ulceration, granular appearances of the villi, nodular pattern, the presence of ulcerations on the mesenteric border, cobblestone appearance, fixed stenosis and/or strictures, and fistulae	26% (8/31)	NA
Chong et al. (2005) [15]	Prospective	22 established CD	VCE ()	Erosions/ulcers	77% (17/21)	NA
			EC ()	Narrowing or an irregular terminal ileum/neoterminal ileum	19% (4/21)	NA
Chong et al. (2005) [15]	Prospective	21 suspected CD	VCE ()	Erosions/ulcers	19% (4/21)	NA
			EC ()	NA	6% (1/16)	NA
Albert et al. (2005) [32]	Prospective	27 established CD	VCE ()	Aphthous mucosal lesions, irregularly shaped or fissural ulcers (occasionally associated with bleeding), cobblestone appearance, luminal narrowing due to oedema and/or fibrous scarring, and granularity with attenuated or lost vascular pattern	93% (13/14)	NA
			EC ()	NA	59% (16/27)	NA
Albert et al. (2005) [32]	Prospective	25 suspected CD	VCE ()	Same as above	92% (12/13)	NA
			EC ()	NA	29% (4/14)	NA

VCE, video capsule endoscopy; NA, not available; SBFT, small bowel follow-through; EC, enteroclysis; CD, Crohn’s disease.
⁽¹⁾No specific criteria for positive findings of CD were provided in the text. Diagnosis was made by a consensus panel of the coinvestigators in this study.