Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
Department of Surgery, Odense University Hospital, Baagoes Alle 31, 5700, Svendborg, Denmark.
Tech Coloproctol. 2023 Dec;27(12):1219-1225. doi: 10.1007/s10151-023-02789-z. Epub 2023 Apr 10.
When an optical colonoscopy is carried out, Scope Guide can assist the endoscopist in determining the localization. In colon capsule endoscopy (CCE), this support is not available. To our knowledge, the interobserver agreement on landmark identification has never been studied. This study aims to investigate the interobserver agreement on landmark identification in CCE.
An interobserver study was carried out comparing the landmark identification (the ileocecal valve, hepatic flexure, splenic flexure, and anus) in CCE investigations between an external private contractor and three in-house CCE readers with different levels of experience. All CCE investigations analyzed in this study were carried out as a part of the Danish screening program for colorectal cancer. Patients were between 50 and 74 years old with a positive fecal immunochemical test (FIT). A random sample of 20 CCE investigations was taken from the total sample of more than 800 videos.
Overall interobserver agreement on all landmarks was 51%. Interobserver agreement on the first cecal image (ileocecal valve), hepatic flexure, splenic flexure, and last rectal image (anus) was 72%, 29%, 22%, and 83%, respectively. The overall interobserver agreement, including only examinations with adequate bowel preparation (n = 16), was 54%, and for individual landmarks, 73%, 32%, 24%, and 85%.
Overall interobserver agreement on all four landmarks from CCE was poor. Measures are needed to improve landmark identification in CCE investigations. Artificial intelligence could be a possible solution to this problem.
在进行光学结肠镜检查时，Scope Guide 可以帮助内镜医生确定定位。在结肠胶囊内镜检查（CCE）中，无法提供这种支持。据我们所知，尚未研究过关于地标识别的观察者间一致性。本研究旨在调查 CCE 中地标识别的观察者间一致性。
进行了一项观察者间研究，比较了外部私人承包商和三位具有不同经验水平的内部 CCE 读者在 CCE 检查中对地标（回盲瓣、肝曲、脾曲和肛门）的识别，这是丹麦结直肠癌筛查计划的一部分。患者年龄在 50 至 74 岁之间，粪便免疫化学检测（FIT）阳性。从超过 800 个视频的总样本中随机抽取了 20 个 CCE 检查。
所有地标总体观察者间一致性为 51%。对第一盲肠图像（回盲瓣）、肝曲、脾曲和最后直肠图像（肛门）的观察者间一致性分别为 72%、29%、22%和 83%。包括仅有充分肠道准备的检查（n=16）在内的总体观察者间一致性为 54%，而对于个别地标，分别为 73%、32%、24%和 85%。
CCE 中所有四个地标总体观察者间一致性较差。需要采取措施来改善 CCE 检查中的地标识别。人工智能可能是解决这个问题的一种方法。
