Accuracy of automatic detection of small-bowel mucosa by second-generation colon capsule endoscopy

Background: Colon capsule endoscopy (CCE) is a noninvasive technique for the detection of colorectal lesions. However, for CCE to be offered as an out-of-clinic procedure, the system needs to automatically alert the patient when to ingest the laxative (booster). Objective: We tested the reliability of the automatic detection of the small-bowel (SB) mucosa and the subsequent alert for booster ingestion by the Data Recorder 3 (DR3) of the second-generation CCE (CCE-2). Design and Setting: Retrospective analysis. Patients and Intervention: Data from 120 consecutive cases of CCE-2 were analyzed for proper DR3 automatic detection of the capsule entering the SB to prompt the patient to ingest the laxative booster. Main Outcome Measurements: Accuracy of the DR3 for detecting the SB mucosa. Results: The DR3 correctly identified the proper time for ingestion of the laxative (booster) in 118 of 120 cases, corresponding to a sensitivity of 98.3% (95% CI, 97%-100%). The median time difference between DR3 automatic SB detection to the observed entrance of the capsule into the SB was 3 minutes 30 seconds (interquartile range 2 minutes 35 seconds to 5 minutes 57 seconds). Limitation: Retrospective analysis. Conclusions: The 98.3% sensitivity of the DR3 for automatic identification of the SB mucosa and subsequent alert for the first laxative (booster) ingestion paves the way for CCE-2 to be offered as an out-of-clinic procedure.