Page 16 - Read Online

Page 10 of 21 Tsuboi et al. Mini-invasive Surg 2024;8:26 https://dx.doi.org/10.20517/2574-1225.2023.94

Table 1. Current state of SBCE and CCE
(1) Clinical indications of SBCE and CCE
SBCE
Suspected small-bowel bleeding
Inflammatory conditions (i.e., Crohn’s disease, Celiac disease, small-bowel lesions associated with vasculitis or collagen disease)
Diagnosis of small-bowel tumors (including gastrointestinal polyposis syndromes, such as familial adenomatous polyposis and Peutz-Jeghers
syndrome)
CCE
Detection of colorectal neoplasm
Evaluation of ulcerative colitis
(2) Current challenges/ limitations to diagnosis
SBCE
Risk of oversight (especially in jejunal lesions)
No consensus of preparation regimen
Burden on the physician
CCE
Need for improved preparation regimens
Burden on the physician
False negative of flat or diminutive lesions
Novel CE modalities
AI-assisted diagnosis reduces the risk of missed diagnoses and alleviates the burden on physicians.
Using a 360° viewing angle may reduce the risk of oversight.
MCCE allows physicians to capture the region of interest
MCCE and ECE help reduce the burden on patients

AI: Artificial intelligence; CE: capsule endoscopy; CCE: colon capsule endoscopy; ECE: esophageal capsule endoscopy; MCCE: magnetically
controlled capsule endoscopy; SBCE: small-bowel capsule endoscopy.

standardized training programs to optimize diagnostic performance.

As technology advances, the indications for ECE are likely to expand beyond screening and surveillance to
include comprehensive diagnostic evaluations of esophageal motility disorders and more precise
assessments of inflammatory conditions, thereby broadening its clinical utility.

Educational program for CE reading
It is important to establish an educational program or e-learning enrollment system for junior physicians
and nurses with limited experience. The importance of training in CE reading has been extensively reported
in the literature, with numerous studies highlighting the beneficial effects of training programs on the
performance of physicians [108-114] . It is widely recognized that completion of a formal and structured CE
training program, aligned with the core CE curriculum guidelines, is essential before granting certification
of competence in performing CE [109,115,116] . Attending the educational program is important, but enhancing
participants’ understanding of the content during their participation is equally crucial. Several reports have
assessed proficiency levels within educational programs [109,115,116] . Incorporating evidence-based training
programs, assessment tools, and certification for junior physicians and nurses is essential to ensure proper
selection of indications for CE and to enhance diagnostic yield through improved lesion recognition and
interpretation.

CURRENT STATUS OF AI FOR CE
[117]
Interpreting SBCE requires approximately 30 min , while CCE reading may take 50 to 60 min [98,99] . A
technical review by the ESGE recommends up to 10 FPS in single-view mode and up to 20 FPS in double-
[39]
or multiple-view modes for reading SBCE . The optimum reading speed for CCE is controversial, but in
clinical practice, a speed of approximately 10 FPS is considered appropriate [118] . The number of images
captured by SBCE exceeds 60,000, and CCE, with its dual cameras, further increases the number.
Maintaining focus while reviewing numerous images can be challenging, particularly because CE is a