A multidisciplinary team from England and Israel compared the sensitivity, specificity, and safety of capsule and push enteroscopy in detecting small-bowel lesions.
Nine to thirteen radiopaque, colored beads (3-6 mm diameter) were sewn in random order inside 9 canine small bowels, half within the first meter. These were confirmed on X-ray.
After recovery, the number, order, and color of beads were assessed in 23 capsule enteroscopies and 9 push enteroscopies in a random order. The surgeons, push enteroscopists, capsule video interpreters, and pathologist were blinded to the others' findings.
The team found that the capsules identified more beads than push enteroscopy (median, 6 vs. 3).
Sensitivity and specificity, respectively:
64% and 92%
37% and 97%
The sensitivity of the capsule was 64% compared with 37% for push enteroscopy.
The specificity was 92% for capsule enteroscopy and 97% for push enteroscopy.
The capsules identified significantly more beads beyond the reach of the push enteroscope (median, 4 vs. 0).
Hair, ingested plastic, ulceration, submucosal swelling, and worms were clearly identified by the capsule. The capsules passed safely through the animals with no significant histologic findings.
Dr Mark Appleyard concluded on behalf of the group that, "In our study, wireless capsule endoscopy detected more abnormalities in the small bowel than push enteroscopy."