Lily O Sullivan, 1, David Poppers, MD2, Seth A. Gross, MD, FACG2 1Yale University, New York, NY; 2NYU Langone Health, New York, NY
Introduction: Colorectal cancer is the third most common cancer for both men and women1. Despite the effectiveness of colon cancer screening only 44% of eligible patients get screened. Often related to not wanting an invasive procedure or not wanting to be sedated. Current non-invasive option include stool based tests, pillcam colon and CT colonography, both requiring a bowel cleanse. Recently there is a new x-ray capsule, which does not require a bowel cleanse prior to ingestion. The case below shows the correlation between x-ray capsule and optical colonoscopy for colon polyp detection.
Case Description/Methods: A 55 year old male with no significant medical problems present for colon cancer screening. He has no family history of colon cancer or polyps. He denies any gastrointestinal complaints. Prior to undergoing colonoscopy, the patient ingests the x-ray capsule, using ultra-low dose x-ray imaging 3-dimensional (3D) images of the colon are created. This is accomplished without needing a bowel cleanse. Scans are taken during capsule motion in the colon and transmitted data to an external recorder unit attached to the patients' lower back. Using both data colon scans and the capsule position tracking a reconstructed 3D colon segments are generated. A 10 mm polyp was identified in the ascending colon. A subsequent colonoscopy was performed identifying the lesion, which was removed by snare polypectomy (Image 1).
Discussion: Colon cancer screening has decreased the mortality of colon cancer. Colonoscopy is the gold standard, but some patients prefer non-invasive option. X-ray capsule is able to achieve 3D imaging using ultra low dose radiation. Future studies are needed to determine of this technology will play a role in colon cancer screening.
References:
P Cathier, S Periaswamy, A Jerebko, M Dundar, J Liang, G Fung, J Stoeckel, T Venkata, R Amara, A Krishnan, B Rao, A Gupta, E Vega, S Laks, A Megibow, M Macari, L Bogoni,. (2004). CAD for polyp detection: An invaluable tool to meet the increasing need for colon-cancer screening. International Congress Series, 1268, 978–982.
Centers for Disease Control and Prevention (CDC) (2001). Trends in screening for colorectal cancer--United States, 1997 and 1999. MMWR. Morbidity and mortality weekly report, 50(9), 162–166.
Figure: Image 1: 3D reconstruction of colon with polyp and image of polyp seen during optical colonoscopy
Disclosures: Lily O Sullivan indicated no relevant financial relationships. David Poppers indicated no relevant financial relationships. Seth Gross indicated no relevant financial relationships.
Lily O Sullivan, 1, David Poppers, MD2, Seth A. Gross, MD, FACG2. P1336 - An Innovative Prep-less X-Ray Imaging Capsule for Colon Polyp Detection, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.
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