Visualisation of the Ampulla of Vater on Small Bowel Capsule Endoscopy

Visualization of lesions on small bowel capsule endoscopy (SBCE) depends on capsule motility. The aim of this study was to assess the delineation of the ampulla of Vater (AoV) across different levels of expertise and reading speeds.

This was a study whereby de-identified SBCE videos were reviewed by scrolling with mouse wheel and then at a speed of 10 frames per second (10 fps). Data regarding delineation of the AoV and bile was collected.

Thirty patients (63.3% males, 63.5 years +/- SD 7.164) were included. The mean detection rate of AoV was higher when the mouse wheel was used than when compared to 10 fps for trainees (35% vs. 21.7%) and experts (33.8% vs 20.5%). The rate of concordance in the delineation of the AoV amongst experts declined with higher reviewing speeds (κ 0.493, p=0.98 mouse wheel vs κ 0.482, p=0.2 10 fps). Experts had a better agreement in detecting AoV than trainees (κ 0.493, p=0.98 vs 0.482, p=0.2 for mouse wheel and 10 fps respectively for experts: κ 0.135, p=0.75 for mouse wheel and 0.109, p=0.2 at 10 fps).

This study demonstrates that visualization of the AoV is dependent on the level of expertise and capsule speed.