title: Utility of 3-dimensional image reconstruction in the diagnosis of small-bowel masses in capsule endoscopy (with video).
abstract: BACKGROUND
  In small-bowel capsule endoscopy (SBCE), differentiating masses (ie, lesions of higher probability for neoplasia) requiring more aggressive intervention from bulges (essentially, false-positive findings) is a challenging task; recently, software that enables 3-dimensional (3D) reconstruction has become available.
  
  
  OBJECTIVE
  To evaluate whether "coupling" 3D reconstructed video clips with the standard 2-dimensional (s2D) counterparts helps in distinguishing masses from bulges.
  
  
  METHODS
  Three expert and 3 novice SBCE readers, blind to others and in a random order, reviewed the s2D video clips and subsequently the s2D clips coupled with their 3D reconstruction (2D+3D).
  
  
  METHODS
  Multicenter study in 3 community hospitals in Italy and a university hospital in Scotland.
  
  
  METHODS
  Thirty-two deidentified 5-minute video clips, containing mucosal bulging (19) or masses (13).
  
  
  METHODS
  3D reconstruction of s2D SBCE video clips.
  
  
  METHODS
  Differentiation of masses from bulges with s2D and 2D+3D video clips, estimated by the area under the receiver operating characteristic curve (AUC); interobserver agreement.
  
  
  RESULTS
  AUC for experts and novices for s2D video clips was .74 and .5, respectively (P = .0053). AUC for experts and novices with 2D+3D was .70 (compared with s2D: P = .245) and .57 (compared s2D: P = .049), respectively. AUC for experts and novices with 2D+3D was similar (P = .1846). The interobserver agreement was good for both experts and novices with the s2D (k = .71 and .54, respectively) and the 2D+3D video clips (k = .58 in both groups).
  
  
  CONCLUSIONS
  Few, short video clips; fixed angle of 3D reconstruction.
  
  
  CONCLUSIONS
  The adjunction of a 3D reconstruction to the s2D video reading platform does not improve the performance of expert SBCE readers, although it significantly increases the performance of novices in distinguishing masses from bulging.
authors.affiliation: Gastroenterology Unit, Valduce Hospital, Como, Italy.
authors.forename: Emanuele
authors.initials: E
authors.lastname: Rondonotti
authors.affiliation: Endoscopy Unit, Centre for Liver & Digestive Disorders, The Royal Infirmary of Edinburgh, Edinburgh, Scotland, UK.
authors.forename: Anastasios
authors.initials: A
authors.lastname: Koulaouzidis
authors.affiliation: National Library of Medicine, National Institutes of Health, Bethesda, Maryland, USA.
authors.forename: Alexandros
authors.initials: A
authors.lastname: Karargyris
authors.affiliation: Faculty of Economics & Management, Open University of Cyprus, Nicosia, Cyprus.
authors.forename: Andry
authors.initials: A
authors.lastname: Giannakou
authors.affiliation: Department of Internal Medicine, Gastroenterology and Digestive Endoscopy Unit, Busto Arsizio Hospital, Busto Arsizio, Italy.
authors.forename: Lucia
authors.initials: L
authors.lastname: Fini
authors.affiliation: Department of Internal Medicine, Gastroenterology Unit, San Carlo Borromeo Hospital, Milan, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Soncini
authors.affiliation: Division of Gastroenterology, Department of Medicine, San Giovanni Battista University Teaching Hospital, Turin, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Pennazio
authors.affiliation: Endoscopy Unit, Centre for Liver & Digestive Disorders, The Royal Infirmary of Edinburgh, Edinburgh, Scotland, UK.
authors.forename: Sarah
authors.initials: S
authors.lastname: Douglas
authors.affiliation: Endoscopy Unit, Centre for Liver & Digestive Disorders, The Royal Infirmary of Edinburgh, Edinburgh, Scotland, UK.
authors.forename: Aman
authors.initials: A
authors.lastname: Shams
authors.affiliation: Endoscopy Unit, Centre for Liver & Digestive Disorders, The Royal Infirmary of Edinburgh, Edinburgh, Scotland, UK.
authors.forename: Neil
authors.initials: N
authors.lastname: Lachlan
authors.affiliation: Endoscopy Unit, Centre for Liver & Digestive Disorders, The Royal Infirmary of Edinburgh, Edinburgh, Scotland, UK.
authors.forename: Ali
authors.initials: A
authors.lastname: Zahid
authors.affiliation: Gastroenterology Unit, Valduce Hospital, Como, Italy.
authors.forename: Giovanna
authors.initials: G
authors.lastname: Mandelli
authors.affiliation: Department of Internal Medicine, Gastroenterology and Digestive Endoscopy Unit, Busto Arsizio Hospital, Busto Arsizio, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Girelli
mesh_terms: D053704:Capsule Endoscopy / Q000379:methods*; D015331:Cohort Studies; D016001:Confidence Intervals; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D021621:Imaging, Three-Dimensional / Q000706:statistics & numerical data*; D007410:Intestinal Diseases / Q000175:diagnosis / Q000473:pathology*; D007414:Intestinal Neoplasms / Q000175:diagnosis / Q000473:pathology; D007421:Intestine, Small / Q000473:pathology*; D008297:Male; D015588:Observer Variation; D012372:ROC Curve; D012680:Sensitivity and Specificity; D014741:Video Recording