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CT-Enterography May Identify Small Bowel Tumors Not Detected by Capsule Endoscopy: Eight Years Experience at Mayo Clinic Rochester

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Abstract

Background

Capsule endoscopy (CE) is widely accepted as the preferred diagnostic test in the evaluation of small bowel diseases. However, small bowel tumors (SBT) are sometimes missed by CE. Preliminary studies suggest that CT-enterography (CTE) may play a role in detecting SBT.

Aims

The purpose of this study was to compare the performance of CE and CTE in detecting SBT

Methods

This was a single center, retrospective study. Patients treated at the Mayo Clinic Rochester between January 2000 and December 2008 with a discharge diagnosis of SBT and negative initial esophagogastroduodenoscopy (EGD) and colonoscopy were identified through a search of the electronic medical records. Among 103 identified patients, 41 had undergone CE, CTE or both, and comprised our study group. The exact binomial sensitivity of CE and CTE in detecting SBT was calculated. Demographic characteristics, clinical presentation, results of diagnostic tests, and tumor characteristics were recorded for each patient.

Results

CTE and CE detected 38/41 (sensitivity 92.7%; 95% CI 80.1–98.5) and 8/27 (sensitivity 29.6%; 95% CI 13.8–50.2) of the SBT identified at Mayo Clinic Rochester, respectively. Seventeen patients had both CTE and CE. In this subgroup of patients, CTE detected SBT in 16/17 (sensitivity 94.1; 95% CI 72.7–99.9) and CE in 6/17 (sensitivity 35.3%; 95% CI 13.3–59). The matched paired difference in the sensitivity of two techniques in detecting SBT was statistically significant (P = 0.004).

Conclusion

CTE may identify SBT not diagnosed by CE.

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None of the authors has a conflict of interest.

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Correspondence to Jeffrey A. Alexander.

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Hakim, F.A., Alexander, J.A., Huprich, J.E. et al. CT-Enterography May Identify Small Bowel Tumors Not Detected by Capsule Endoscopy: Eight Years Experience at Mayo Clinic Rochester. Dig Dis Sci 56, 2914–2919 (2011). https://doi.org/10.1007/s10620-011-1773-0

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