The Use of Three-Dimensional Reconstruction Software in Oesophageal Capsule Endoscopy: A Pilot Study from Edinburgh

Introduction : Oesophageal capsule endoscopy (OCE) is used in the detection of oesophageal varices (OVs). In such context, application of innovative 3-D reconstruction software may improve OCE accuracy. Methods : Fourteen OCE recordings were deconstructed to individual frames, 3-D reconstructed and re-stitched to 3-D videos. Six novice and 4 experienced reviewers read the OCE first in 2-D and then with 2-D / 3-D views. The consensus opinion of 3 hepatologists was used as reference standard (RS). Inter-observer agreement was checked with kappa (κ) statistics. When the RS for C2 (i.e. big OVs) was taken into account, the negative predictive value (NPV) of all reviewers for C2 OVs with 2-D and combined 2-D /3-D was calculated. Moreover, ROC curve analysis was performed. Results : The inter-observer agreement for the entire group, novices, experienced and experts with 2-D was 0.145, 0.118, 0.125 and 0.025, respectively. The inter- observer agreement for the entire group, novice, experienced and experts with 2-D / 3-D was 0.215, 0.104, 0.222 and 0.372, respectively. For C2 OVs, the NPV of 2-D and 2-D / 3-D review was 66.6% and 80%, respectively. Conclusion : In OCE, a 3-D reconstruction software leads to improved diagnostic agreement; furthermore, it improves significantly NPV of OCE for C2 varices.