title: CT-enterography may identify small bowel tumors not detected by capsule endoscopy: eight years experience at Mayo Clinic Rochester.
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.
  
  
  OBJECTIVE
  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).
  
  
  CONCLUSIONS
  CTE may identify SBT not diagnosed by CE.
authors: General Internal Medicine, Mayo Clinic, Rochester, MN, USA.
authors: Fayaz A
authors: FA
authors: Hakim
authors: Jeffrey A
authors: JA
authors: Alexander
authors: James E
authors: JE
authors: Huprich
authors: Madhusudan
authors: M
authors: Grover
authors: Felicity T
authors: FT
authors: Enders
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D053704:Capsule Endoscopy; D002276:Carcinoid Tumor / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D046152:Gastrointestinal Stromal Tumors / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D007082:Ileum / Q000000981:diagnostic imaging / Q000473:pathology; D007414:Intestinal Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D007583:Jejunum / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008875:Middle Aged; D008910:Minnesota; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed