Boal Carvalho P1, Magalhães J1, Dias DE Castro F1, Monteiro S1, Rosa B1, Moreira MJ1, Cotter J1,2,3.
1Hospital Senhora da Oliveira, Guimarães, Portugal.
2Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho. Campus Gualtar, Braga, Portugal.
3ICVS/3B's, PT Government Associate Laboratory, Guimarães, Braga, Portugal.
ABSTRACT
Background
Small bowel bleeding is a leading indication for small bowel capsule endoscopy. The Suspected Blood Indicator (SBI) is a software feature directed to automatically detect bleeding lesions during small bowel capsule endoscopy.
Objective
We aimed to assess SBI diagnostic accuracy for small bowel haemorrhage or potentially bleeding lesions during small bowel capsule endoscopy for small bowel bleeding.
Methods
Single-centre retrospective study including 281 consecutive small bowel capsule endoscopy performed for small bowel bleeding during 6 years. The investigators marked lesions with high bleeding potential (P2), such as angioectasias, ulcers and tumours, as well as active bleeding during regular small bowel capsule endoscopy viewing with PillCam SB2®. All small bowel capsule endoscopy were independently reviewed by another central reader using SBI.
Results
Among the 281 patients, 29 (10,3%) presented with active haemorrhage while 81 (28,9%) presented with a P2 lesion. The most frequently observed P2 lesions were angioectasias (52), ulcers (15), polyps (7) and ulcerated neoplasias (7). SBI showed a 96,6% (28/29) sensitivity for active small bowel bleeding, with a 97,7% negative predictive value. Regarding P2 lesions, the SBI displayed an overall sensitivity of 39.5%, being highest for ulcerated neoplasias (100%), but significantly lower for angioectasias (38.5%) or ulcers (20.0%).
Conclusion
Although SBI sensitivity for the automatic detection of potentially bleeding lesions was low, it effectively detected active small bowel bleeding with very high sensitivity and negative predictive value.
