Capsule Endoscopy vs MRE

[crohnsinct]

Wow!

Comparison of Capsule Endoscopy and Magnetic Resonance Enterography for the Assessment of Small Bowel Lesions in Crohn’s Disease
Begoña González-Suárez, MD, PhD Sonia Rodriguez, MD Elena Ricart, MD, PhD Ingrid Ordás, MD, PhD Jordi Rimola, MD, PhD Álvaro Díaz-González, MD Cristina Romero, MD Cristina Rodríguez de Miguel Arantxa Jáuregui, MD Isis K Araujo, MD ... Show more
Inflammatory Bowel Diseases, izx107, https://doi.org/10.1093/ibd/izx107
Published: 01 March 2018 Article history
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Abstract
Background and Aims
Diagnostic yield of Small Bowel Capsule Endoscopy (SBCE) for the assessment of small bowel (SB) lesions is higher than radiologic imaging techniques. However, magnetic resonance enterography (MRE) data are scarce and inconclusive. Colon Capsule Endoscopy (CCE) is a new capsule modality. The primary aim of our study was to compare MRE and capsule endoscopy (CE) for the assessment of Crohn’s disease (CD). The secondary objectives were to compare the diagnostic accuracy of both CE modalities and changes in Montreal classification after each examination.
Methods
We included 47 patients with established (n = 32) or suspected CD (n = 15). MRE was performed first to rule out strictures. In patients with a suspected stricture by MRE, an Agile Patency Capsule was performed. SB disease activity was measured by MaRIA score (MRE) and Lewis Index (CE).
Results
SB lesions were found in 36 of47 patients with CE and in 21 of47 patients with MRE (76.6% vs 44.7%, P = 0.001). Jejunal inflammation was detected by CE in 31.9% of patients and by MRE in 6.4% of patients (15/47 vs 3/47; P = 0.03); lesions in ileum were detected in 57.4% of patients by CE, and in 21.3% of patients by MRE (27/ 47 vs 10/ 47; P = 0.04). Finally, in terminal ileum, CE showed lesions in 68.1% (32/47) of patients, whereas MRE detected lesions in 38.3% (18/ 47 patients), (P = 0.001). The original Montreal classification was changed in 53.1% of patients (25/ 47) based on CE findings and in 12.7% of patients (6/47) based on MRE findings (P < 0.05).
Conclusions
In our cohort CE was significantly superior to MRE for detecting SB lesions, mainly superficial and proximal lesions. CE is useful for a appropriate patients’ classification according to Montreal classification.

 

[pdx]

Thanks for posting that--really interesting.

 

[Maya142]

Very interesting! Our GI prefers pillcams, but it seems like MREs are done more. She said it can be hard to get some insurance companies to cover pillcams that are not done for diagnostic purposes and that was our experience.

Our insurance company did not initially cover it since my daughter was already diagnosed, but after appealing and fighting with them, they did cover most of it.

 

[my little penguin]

MRE show scar tissue and thickening fistula etc...
Which can’t be seen at all on a pill cam
Pill cam can see ulceration but can take biopsy of normal looking tissue
Both aspects are important part of understanding where the disease is at and how it progresses

 

[Lady Organic]

I thought these exams would have much higher accuracy and precision, I am quite surprised... This means a lot of sick people undergo these exams and fail to get a diagnosis. Thats pretty sad.