[Imaging in gastroenterology--what is new?]

Area of Science:

• Medical imaging
• Gastroenterology
• Radiology

Background:

• Advancements in endoscopic, radiological, and sonographical imaging have introduced new diagnostic tools.
• Virtual colonoscopy, capsule endoscopy, and contrast-enhanced sonography offer novel approaches to medical diagnosis.

Purpose of the Study:

• To evaluate the effectiveness and implications of emerging imaging techniques.
• To assess the diagnostic capabilities and clinical utility of virtual colonoscopy, capsule endoscopy, and contrast-enhanced sonography.

Main Methods:

• Review of recent developments in virtual colonoscopy, capsule endoscopy, and contrast-enhanced sonography.
• Analysis of sensitivity, diagnostic superiority, and potential impact on therapeutic procedures for each technique.

Main Results:

• MR- or CT-colonography demonstrates high sensitivity (approx. 90%) for detecting polyps > 1 cm, but requires bowel preparation and incurs high costs.
• Capsule endoscopy surpasses push-enteroscopy for small bowel disease diagnosis, though its impact on treatment and cost-justification are under investigation.
• Contrast-enhanced sonography enhances detection and characterization of liver lesions, potentially reducing the need for CT and MR examinations.

Conclusions:

• While advanced imaging techniques offer significant diagnostic improvements, considerations regarding patient preparation, cost-effectiveness, and impact on clinical practice remain crucial.
• Further research is needed to establish the routine clinical utility and cost-benefit of capsule endoscopy.
• Contrast-enhanced sonography shows potential to streamline liver lesion diagnosis, possibly replacing other imaging modalities.