Capsule endoscopy: comparison of two different reading modes

Capsule endoscopy (CE) is a very useful tool for the evaluation of the small intestine, but it is time consuming. The aim of this study was to compare evaluation times and detection rates in two different reading modes (single view at a speed of 10 frames per second (fps) and four images simultaneously, i.e., quadview mode at a speed of 20 fps) to find the optimum setting mode for evaluation of CE videos.

CE videos of 70 patients performed for different indications (obscure bleeding, n = 50; suspected Crohn's disease, n = 10; and suspected or complicated celiac disease, n = 10) were reviewed by investigators A and B in the two different reading modes.

The mean evaluation time using single view at 10 fps was 22 min (SD ± 9.1 min) and 11.9 min (SD ± 4.8 min) using quadview mode at 20 fps. The detection rates of angiodysplasias, erosions, small ulcers, and small polyps were only discreetly lower using the quadview mode at 20 fps. In Crohn's disease and celiac disease, the essential aspects of inflamed or atrophic mucosa segments were equally detected in both reading modes. In one case of complicated celiac disease with severe erosive jejunitis, a lymphoma-suspect lesion was overlooked in the quadview mode at 20 fps.

It is often possible to read CE videos in quadview mode at a higher speed with even so a high diagnostic yield in a shortened evaluation time.