Freitas Marta, Arieira Cátia, Carvalho Pedro Boal, Rosa Bruno, Moreira Maria João, Cotter José
Gastroenterology Department, Hospital da Senhora da Oliveira, Guimarães, Portugal.
Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.
Scand J Gastroenterol. 2020 Apr;55(4):408-413. doi: 10.1080/00365521.2020.1745880. Epub 2020 Mar 31.
Capsule endoscopy is a widely recognized method to study the small bowel, including in patients with Crohn's disease (CD). The Lewis score (LS) is a valuable tool in this setting, able to assess inflammatory activity. TOP100, a new software tool of the RAPID Reader, emerged to assist in the time-consuming capsule reading process, by automatically selecting 100 images that will most likely contain abnormalities. Evaluate the agreement between TOP100 and classic reading (CR) in determining LS in the setting of CD. Retrospective study including consecutive patients undergoing small bowel capsule endoscopy (SBCE) for suspected or established CD. One experienced reader performed CR and calculated the LS. Another experienced reader, blinded to the CR results, reviewed all SBCE videos using TOP100 and calculated the LS. One hundred and fifteen patients were included. SBCE detected significant inflammatory activity (LS ≥135) in 64 patients (55.7%). We verified a strong agreement between the two methods of capsule reading (Kappa = 0.83, < .001), with an agreement on 89.6% of the cases. The agreement was superior in moderate-to-severe inflammatory activity (Kappa = 0.92, < .001). All cases of moderate-to-severe activity detected by CR were identified by TOP100 as significant inflammatory activity. A good agreement was verified in all tertiles ( < .001). Although the classical review of the entire video remains the gold standard, the TOP100 has been shown to be a useful tool in assisting the reader in a prompt calculation of LS, in particular for identifying patients with moderate-to-severe inflammatory disease.
胶囊内镜检查是一种广泛认可的用于研究小肠的方法，包括在克罗恩病（CD）患者中。刘易斯评分（LS）是在这种情况下评估炎症活动的一种有价值的工具。TOP100是RAPID Reader的一种新软件工具，它通过自动选择100张最有可能包含异常的图像，来协助耗时的胶囊内镜图像解读过程。评估在CD患者中，TOP100与传统解读（CR）在确定LS方面的一致性。回顾性研究纳入了因疑似或确诊CD而接受小肠胶囊内镜检查（SBCE）的连续患者。一名经验丰富的阅片者进行CR并计算LS。另一名经验丰富的阅片者在不知道CR结果的情况下，使用TOP100查看所有SBCE视频并计算LS。共纳入115例患者。SBCE在64例患者（55.7%）中检测到显著炎症活动（LS≥135）。我们验证了两种胶囊内镜解读方法之间有很强的一致性（Kappa = 0.83，P < 0.001），在89.6%的病例中达成一致。在中度至重度炎症活动中一致性更好（Kappa = 0.92，P < 0.001）。CR检测到的所有中度至重度活动病例，TOP100均将其识别为显著炎症活动。在所有三分位数中均验证了良好的一致性（P < 0.001）。虽然对整个视频进行传统解读仍然是金标准，但TOP100已被证明是一种有用的工具，可协助阅片者快速计算LS，特别是用于识别中度至重度炎症性疾病患者。
