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

• Published in: Digestive diseases and sciences Vol. 56; no. 10; pp. 2914 - 2919
• Main Authors: Hakim, Fayaz A., Alexander, Jeffrey A., Huprich, James E., Grover, Madhusudan, Enders, Felicity T.
• Format: Journal Article
• Language: English
• Published: Boston Springer US 01.10.2011; Springer; Springer Nature B.V
• Subjects: Adenocarcinoma - diagnosis; Adenocarcinoma - diagnostic imaging; Adenocarcinoma - pathology; Adult; Aged; Aged, 80 and over; Biochemistry; Biological and medical sciences; Capsule Endoscopy; Carcinoid Tumor - diagnosis; Carcinoid Tumor - diagnostic imaging; Carcinoid Tumor - pathology; Care and treatment; Colonoscopy; Colorectal cancer; Digestive system; Feeding. Feeding behavior; Female; Fundamental and applied biological sciences. Psychology; Gastroenterology; Gastroenterology. Liver. Pancreas. Abdomen; Gastrointestinal diseases; Gastrointestinal Stromal Tumors - diagnosis; Gastrointestinal Stromal Tumors - diagnostic imaging; Gastrointestinal Stromal Tumors - pathology; Hepatology; Humans; Ileum - diagnostic imaging; Ileum - pathology; Intestinal Neoplasms - diagnosis; Intestinal Neoplasms - diagnostic imaging; Intestinal Neoplasms - pathology; Investigative techniques, diagnostic techniques (general aspects); Jejunum - diagnostic imaging; Jejunum - pathology; Male; Medical records; Medical research; Medical sciences; Medicine; Medicine & Public Health; Medicine, Experimental; Middle Aged; Minnesota; Oncology; Original Article; Radiodiagnosis. Nmr imagery. Nmr spectrometry; Retrospective Studies; Sensitivity and Specificity; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Technical education; Tomography, X-Ray Computed; Transplant Surgery; Tumors; Vertebrates: anatomy and physiology, studies on body, several organs or systems; CT-enterography; Capsule endoscopy; Small bowel tumors; Radiodiagnosis; Gastroenterology; Medical imagery; Digestive diseases; Intestinal disease; Metabolic diseases; Computerized axial tomography; CT enteroclysis; Small bowel tumour
• ISSN: 0163-2116; 1573-2568
• DOI: 10.1007/s10620-011-1773-0

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.