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Evaluating the Performance of the TOP100 Tool in Detecting Key Small Bowel Findings at Capsule Endoscopy
Aishwarya Devanand1,2, Cristina Caranfil1,3, Michaela Moore1,2
1Academic Unit of Gastroenterology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield S10 2JF, UK.
Diagnostics (Basel, Switzerland)
|July 15, 2026
Summary
Standard human reading (SR) of capsule endoscopy (CE) shows higher diagnostic yield than AI software TOP100. However, TOP100 may assist expert readers in prioritizing cases, especially in busy centers.
Area of Science:
- Gastroenterology
- Medical Imaging
- Artificial Intelligence in Medicine
Background:
- Capsule endoscopy (CE) is crucial for small bowel evaluation but faces challenges with prolonged reading times and reader fatigue.
- Artificial intelligence (AI)-integrated software offers potential solutions to enhance CE reading efficiency and accuracy.
Purpose of the Study:
- To assess the diagnostic performance of the AI-powered TOP100 software compared to standard human reading (SR) for capsule endoscopy.
- To evaluate performance across various clinical indications, including inflammatory bowel disease (IBD) and iron-deficiency anaemia (IDA).
Main Methods:
- A retrospective cohort study involving 1374 PillCam™SB3 CE examinations.
- Comparison of findings between expert human readers (SR) and blinded reading with TOP100 software.
- Analysis of diagnostic yield, sensitivity, and specificity for various small bowel pathologies.
Main Results:
- Standard reading (SR) demonstrated a significantly higher diagnostic yield (36.0%) than TOP100 (27.5%).
- TOP100 showed moderate sensitivity and high specificity for active bleeding and angiodysplasia.
- In IBD cases, TOP100 improved sensitivity for detecting erosions by 9.4% while ulcer detection was comparable to SR.
Conclusions:
- Standard human reading remains the gold standard for capsule endoscopy interpretation.
- TOP100 AI software can serve as a valuable adjunct tool for supporting interpretation and prioritizing cases in high-volume settings.
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