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Surveillance of FAP: a prospective blinded comparison of capsule endoscopy and other GI imaging to detect small bowel polyps
BACKGROUND: Familial adenomatous polyposis (FAP) is a hereditary disorder characterized by polyposis along the gastrointestinal tract. Information on adenoma status below the duodenum has previously been restricted due to its inaccessibility in vivo. Capsule Endoscopy (CE) may provide a useful adjun...
Autores principales: | , , , , , , , , |
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Formato: | Texto |
Lenguaje: | English |
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BioMed Central
2010
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2859487/ https://www.ncbi.nlm.nih.gov/pubmed/20361877 http://dx.doi.org/10.1186/1897-4287-8-3 |
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author | Tescher, Paul Macrae, Finlay A Speer, Tony Stella, Damien Gibson, Robert Tye-Din, Jason A Srivatsa, Geeta Jones, Ian T Marion, Kaye |
author_facet | Tescher, Paul Macrae, Finlay A Speer, Tony Stella, Damien Gibson, Robert Tye-Din, Jason A Srivatsa, Geeta Jones, Ian T Marion, Kaye |
author_sort | Tescher, Paul |
collection | PubMed |
description | BACKGROUND: Familial adenomatous polyposis (FAP) is a hereditary disorder characterized by polyposis along the gastrointestinal tract. Information on adenoma status below the duodenum has previously been restricted due to its inaccessibility in vivo. Capsule Endoscopy (CE) may provide a useful adjunct in screening for polyposis in the small bowel in FAP patients. This study aims to evaluate the effectiveness of CE in the assessment of patients with FAP, compared to other imaging modalities for the detection of small bowel polyps. METHOD: 20 consecutive patients with previously diagnosed FAP and duodenal polyps, presenting for routine surveillance of polyps at The Royal Melbourne Hospital were recruited. Each fasted patient initially underwent a magnetic resonance image (MRI) of the abdomen, and a barium small bowel follow-through study. Capsule Endoscopy was performed four weeks later on the fasted patient. An upper gastrointestinal side-viewing endoscopy was done one (1) to two (2) weeks after this. Endoscopists and investigators were blinded to results of other investigations and patient history. RESULTS: Within the stomach, upper gastrointestinal endoscopy found more polyps than other forms of imaging. SBFT and MRI generally performed poorly, identifying fewer polyps than both upper gastrointestinal and capsule endoscopy. CE was the only form of imaging that identified polyps in all segments of the small bowel as well as the only form of imaging able to provide multiple findings outside the stomach/duodenum. CONCLUSION: CE provides important information on possible polyp development distal to the duodenum, which may lead to surgical intervention. The place of CE as an adjunct in surveillance of FAP for a specific subset needs consideration and confirmation in replication studies. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12608000616370 |
format | Text |
id | pubmed-2859487 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2010 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-28594872010-04-27 Surveillance of FAP: a prospective blinded comparison of capsule endoscopy and other GI imaging to detect small bowel polyps Tescher, Paul Macrae, Finlay A Speer, Tony Stella, Damien Gibson, Robert Tye-Din, Jason A Srivatsa, Geeta Jones, Ian T Marion, Kaye Hered Cancer Clin Pract Research BACKGROUND: Familial adenomatous polyposis (FAP) is a hereditary disorder characterized by polyposis along the gastrointestinal tract. Information on adenoma status below the duodenum has previously been restricted due to its inaccessibility in vivo. Capsule Endoscopy (CE) may provide a useful adjunct in screening for polyposis in the small bowel in FAP patients. This study aims to evaluate the effectiveness of CE in the assessment of patients with FAP, compared to other imaging modalities for the detection of small bowel polyps. METHOD: 20 consecutive patients with previously diagnosed FAP and duodenal polyps, presenting for routine surveillance of polyps at The Royal Melbourne Hospital were recruited. Each fasted patient initially underwent a magnetic resonance image (MRI) of the abdomen, and a barium small bowel follow-through study. Capsule Endoscopy was performed four weeks later on the fasted patient. An upper gastrointestinal side-viewing endoscopy was done one (1) to two (2) weeks after this. Endoscopists and investigators were blinded to results of other investigations and patient history. RESULTS: Within the stomach, upper gastrointestinal endoscopy found more polyps than other forms of imaging. SBFT and MRI generally performed poorly, identifying fewer polyps than both upper gastrointestinal and capsule endoscopy. CE was the only form of imaging that identified polyps in all segments of the small bowel as well as the only form of imaging able to provide multiple findings outside the stomach/duodenum. CONCLUSION: CE provides important information on possible polyp development distal to the duodenum, which may lead to surgical intervention. The place of CE as an adjunct in surveillance of FAP for a specific subset needs consideration and confirmation in replication studies. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12608000616370 BioMed Central 2010-04-04 /pmc/articles/PMC2859487/ /pubmed/20361877 http://dx.doi.org/10.1186/1897-4287-8-3 Text en Copyright ©2010 Tescher et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Tescher, Paul Macrae, Finlay A Speer, Tony Stella, Damien Gibson, Robert Tye-Din, Jason A Srivatsa, Geeta Jones, Ian T Marion, Kaye Surveillance of FAP: a prospective blinded comparison of capsule endoscopy and other GI imaging to detect small bowel polyps |
title | Surveillance of FAP: a prospective blinded comparison of capsule endoscopy and other GI imaging to detect small bowel polyps |
title_full | Surveillance of FAP: a prospective blinded comparison of capsule endoscopy and other GI imaging to detect small bowel polyps |
title_fullStr | Surveillance of FAP: a prospective blinded comparison of capsule endoscopy and other GI imaging to detect small bowel polyps |
title_full_unstemmed | Surveillance of FAP: a prospective blinded comparison of capsule endoscopy and other GI imaging to detect small bowel polyps |
title_short | Surveillance of FAP: a prospective blinded comparison of capsule endoscopy and other GI imaging to detect small bowel polyps |
title_sort | surveillance of fap: a prospective blinded comparison of capsule endoscopy and other gi imaging to detect small bowel polyps |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2859487/ https://www.ncbi.nlm.nih.gov/pubmed/20361877 http://dx.doi.org/10.1186/1897-4287-8-3 |
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