Third-Generation Capsule Endoscopy Outperforms Second-Generation Based on the Detectability of Esophageal Varices

Area of Science:

• Gastroenterology
• Medical Imaging
• Endoscopy

Background:

• Second-generation (SB2) and third-generation (SB3) capsule endoscopy systems are used for visualizing the gastrointestinal tract.
• SB3 offers higher image resolution than SB2.
• Esophageal varices (EVs) are a serious complication of liver cirrhosis.

Purpose of the Study:

• To compare the diagnostic performance of SB2 and SB3 in detecting esophageal varices (EVs).
• To evaluate the detectability of different forms, locations, and red color signs of EVs using both capsule endoscopy systems.

Main Methods:

• A comparative study involving 76 patients with SB3 and 99 patients with SB2.
• Esophagogastroduodenoscopy (EGD) served as the gold standard for diagnosis within one month prior to capsule endoscopy.
• Evaluation of EV diagnosis based on form (F0-F3), location (Ls, Lm, Li), and red color (RC) sign.

Main Results:

• Overall diagnostic rates for EVs did not significantly differ between SB2 and SB3.
• SB3 demonstrated significantly higher diagnostic rates for EV form F1 (81% vs. 52%) and location Li (84% vs. 52%) compared to SB2.
• Sensitivity for EV diagnosis was higher with SB3 (81%) than SB2 (65%), while specificity remained 100% for both.

Conclusions:

• Third-generation capsule endoscopy (SB3) significantly improves the detectability of esophageal varices compared to the second-generation (SB2).
• SB3 shows enhanced capability in identifying specific forms and locations of EVs, aiding in more accurate diagnosis and patient management.