title: Colon capsule versus CT colonography in patients with incomplete colonoscopy: a prospective, comparative trial.
abstract: OBJECTIVE
  In case of incomplete colonoscopy, several radiologic methods have traditionally been used, but more recently, capsule endoscopy was also shown to be accurate. Aim of this study was to compare colon capsule endoscopy (CCE) and CT colonography (CTC) in a prospective cohort of patients with incomplete colonoscopy.
  
  
  METHODS
  Consecutive patients with a previous incomplete colonoscopy underwent CCE and CTC followed by colonoscopy in case of positive findings on either test (polyps/mass lesions ≥6 mm). Clinical follow-up was performed in the other cases to rule out missed cancer. CTC was performed after colon capsule excretion or 10-12 h postingestion. Since the gold standard colonoscopy was performed only in positive cases, diagnostic yield and positive predictive values of CCE and CTC were used as study end-points.
  
  
  RESULTS
  100 patients were enrolled. CCE and CTC were able to achieve complete colonic evaluation in 98% of cases. In a per-patient analysis for polyps ≥6 mm, CCE detected 24 patients (24.5%) and CTC 12 patients (12.2%). The relative sensitivity of CCE compared to CTC was 2.0 (95% CI 1.34 to 2.98), indicating a significant increase in sensitivity for lesions ≥6 mm. Of larger polyps (≥10 mm), these values were 5.1% for CCE and 3.1% for CTC (relative sensitivity: 1.67 (95% CI 0.69 to 4.00)). Positive predictive values for polyps ≥6 mm and ≥10 mm were 96% and 85.7%, and 83.3% and 100% for CCE and CTC, respectively. No missed cancer occurred at clinical follow-up of a mean of 20 months.
  
  
  CONCLUSIONS
  CCE and CTC were of comparable efficacy in completing colon evaluation after incomplete colonoscopy; the overall diagnostic yield of colon capsule was superior to CTC.
  
  
  BACKGROUND
  NCT01525940.
authors: Digestive Endoscopy Unit, Catholic University, Rome, Italy.
authors: Cristiano
authors: C
authors: Spada
authors: Digestive Endoscopy Unit, Catholic University, Rome, Italy.
authors: Cesare
authors: C
authors: Hassan
authors: Department of Bioimaging and Radiological Sciences, Catholic University, Rome, Italy.
authors: Brunella
authors: B
authors: Barbaro
authors: Department of Radiological Sciences, Oncology and Pathology, Sapienza University, Rome, Italy.
authors: Franco
authors: F
authors: Iafrate
authors: Digestive Endoscopy Unit, Catholic University, Rome, Italy.
authors: Paola
authors: P
authors: Cesaro
authors: Digestive Endoscopy Unit, Catholic University, Rome, Italy.
authors: Lucio
authors: L
authors: Petruzziello
authors: Digestive Endoscopy Unit, Catholic University, Rome, Italy.
authors: Leonardo
authors: L
authors: Minelli Grazioli
authors: Epidemiologia dei Tumori II, AOU S Giovanni Battista-CPO Piemonte Torino, Torino, Italy.
authors: Carlo
authors: C
authors: Senore
authors: Department of Bioimaging and Radiological Sciences, Catholic University, Rome, Italy.
authors: Gabriella
authors: G
authors: Brizi
authors: Digestive Endoscopy Unit, Catholic University, Rome, Italy.
authors: Isabella
authors: I
authors: Costamagna
authors: Department of Bioimaging and Radiological Sciences, Catholic University, Rome, Italy.
authors: Giuseppe
authors: G
authors: Alvaro
authors: Department of Radiological Sciences, Oncology and Pathology, Sapienza University, Rome, Italy.
authors: Marcella
authors: M
authors: Iannitti
authors: Department of Bioimaging and Radiological Sciences, Catholic University, Rome, Italy.
authors: Marco
authors: M
authors: Salsano
authors: Department of Radiological Sciences, Oncology and Pathology, Sapienza University, Rome, Italy.
authors: Maria
authors: M
authors: Ciolina
authors: Department of Radiological Sciences, Oncology and Pathology, Sapienza University, Rome, Italy.
authors: Andrea
authors: A
authors: Laghi
authors: Department of Bioimaging and Radiological Sciences, Catholic University, Rome, Italy.
authors: Lorenzo
authors: L
authors: Bonomo
authors: Digestive Endoscopy Unit, Catholic University, Rome, Italy.
authors: Guido
authors: G
authors: Costamagna
mesh_terms: D000328:Adult; D000368:Aged; D053704:Capsule Endoscopy / Q000009:adverse effects / Q000379:methods*; D003111:Colonic Polyps / Q000175:diagnosis* / Q000473:pathology; D023881:Colonography, Computed Tomographic / Q000009:adverse effects / Q000379:methods*; D003113:Colonoscopy / Q000009:adverse effects / Q000379:methods*; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000473:pathology; D005189:False Positive Reactions; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D016037:Single-Blind Method
keywords: Colonoscopy