CC BY-NC-ND 4.0 · Endosc Int Open 2018; 06(07): E844-E850
DOI: 10.1055/a-0577-2897
Original article
Owner and Copyright © Georg Thieme Verlag KG 2018

Development of a computed cleansing score to assess quality of bowel preparation in colon capsule endoscopy

Aymeric Becq
1  Saint-Antoine Hospital, AP-HP, Department of Hepatogastroenterology, 184 rue du Faubourg Saint Antoine, 75012 Paris, France
2  Sorbonne University, Paris, France
,
Aymeric Histace
3  ETIS UMR 8051, University Paris-Seine, University of Cergy-Pontoise, ENSEA, CNRS, Cergy, France
,
Marine Camus
1  Saint-Antoine Hospital, AP-HP, Department of Hepatogastroenterology, 184 rue du Faubourg Saint Antoine, 75012 Paris, France
2  Sorbonne University, Paris, France
,
Isabelle Nion-Larmurier
1  Saint-Antoine Hospital, AP-HP, Department of Hepatogastroenterology, 184 rue du Faubourg Saint Antoine, 75012 Paris, France
,
Einas Abou Ali
1  Saint-Antoine Hospital, AP-HP, Department of Hepatogastroenterology, 184 rue du Faubourg Saint Antoine, 75012 Paris, France
,
Olivia Pietri
1  Saint-Antoine Hospital, AP-HP, Department of Hepatogastroenterology, 184 rue du Faubourg Saint Antoine, 75012 Paris, France
2  Sorbonne University, Paris, France
,
Olivier Romain
3  ETIS UMR 8051, University Paris-Seine, University of Cergy-Pontoise, ENSEA, CNRS, Cergy, France
,
Ulriikka Chaput
1  Saint-Antoine Hospital, AP-HP, Department of Hepatogastroenterology, 184 rue du Faubourg Saint Antoine, 75012 Paris, France
,
Cynthia Li
1  Saint-Antoine Hospital, AP-HP, Department of Hepatogastroenterology, 184 rue du Faubourg Saint Antoine, 75012 Paris, France
4  College of Arts and Sciences, Drexel University, Philadelphia, Pennsylvania, United States
,
Philippe Marteau
1  Saint-Antoine Hospital, AP-HP, Department of Hepatogastroenterology, 184 rue du Faubourg Saint Antoine, 75012 Paris, France
2  Sorbonne University, Paris, France
,
Christian Florent
1  Saint-Antoine Hospital, AP-HP, Department of Hepatogastroenterology, 184 rue du Faubourg Saint Antoine, 75012 Paris, France
2  Sorbonne University, Paris, France
,
Xavier Dray
1  Saint-Antoine Hospital, AP-HP, Department of Hepatogastroenterology, 184 rue du Faubourg Saint Antoine, 75012 Paris, France
2  Sorbonne University, Paris, France
3  ETIS UMR 8051, University Paris-Seine, University of Cergy-Pontoise, ENSEA, CNRS, Cergy, France
› Author Affiliations
Further Information

Publication History

submitted 10 August 2017

accepted after revision 27 December 2017

Publication Date:
04 July 2018 (online)

Abstract

Background and study aims Colon capsule endoscopy (CCE) does not possess an objective and reliable scoring system to assess the quality of visualization of the colon mucosa. The aim of this study was to establish a colonic computed assessment of cleansing (CAC) score able to discriminate “adequately cleansed” from “inadequately cleansed” CCE still frames.

Patients and methods Twelve normal and complete CCEs, using the Pillcam Colon 2 system (Medtronic, Minnesota, United States), were prospectively selected amongst a database. A CAC score, defined as the ratio of color intensities red over green (R/G ratio), and red over brown (R/(R + G) ratio) was calculated for each extracted colonic frame. After sorting and random selection, two sets of still frames representative of the range of these ratios were obtained. These images were analyzed twice in random order by two experienced CCE readers who were blinded to the CAC scores. A receiver operating characteristic (ROC) curve was forged for both types of ratios and a threshold established, yielding the highest diagnostic performance in terms of adequate cleansing assessment.

Results Four-hundred-and-eight frames were extracted. Regarding the R/G ratio, a threshold value of 1.55 was calculated, with a sensitivity of 86.5 % and a specificity of 77.7 %. Regarding the R/(R + G) ratio, a threshold value of 0.58 was calculated with a sensitivity of 95.5 % and a specificity of 62.9 %.

Conclusion The two proposed CAC scores based on the ratio of color intensities come with high sensitivities for discriminating between “adequately cleansed” and “inadequately cleansed” CCE still frames, but they lack specificity. Further refinement, with implementation of additional image parameters, is warranted.