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Coeliac disease and the videocapsule: what have we learned till now.

Authors
  • Ciaccio, Edward J1
  • Lewis, Suzanne K1
  • Bhagat, Govind1, 2
  • Green, Peter H1
  • 1 Department of Medicine, Celiac Disease Center, Columbia University Medical Center, New York, NY, USA.
  • 2 Department of Pathology and Cell Biology, Columbia University Medical Center, New York, NY, USA.
Type
Published Article
Journal
Annals of translational medicine
Publication Date
May 01, 2017
Volume
5
Issue
9
Pages
197–197
Identifiers
DOI: 10.21037/atm.2017.05.06
PMID: 28567377
Source
Medline
Keywords
License
Unknown

Abstract

Celiac disease is diagnosed in part by finding areas of pathology in the small bowel (SB) mucosa. This can often be difficult because the pathologic alterations, including atrophy of the small intestinal villi, can often be sparse and subtle. Some of the quantitative methods for detecting and measuring the presence of villous atrophy from videocapsule endoscopy (VCE) images are presented and discussed. These methods consist of static features of measurement including texture, gray level, and presence and abundance of fissures contained within each acquired image. The methods also consist of dynamic measurements including spectral analysis, and determining motion from a sequence of endoscopic images as obtained from a VCE clip. Thus far, several methods have been found useful to characterize the SB mucosa of untreated celiac disease patients versus control patients lacking villous atrophy, which have revealed significant differences in texture, frequency, and motion on analysis of VCE. In untreated celiac patients undergoing endoscopy, there tends to be greater magnitude of changes and spatial differences in textural descriptors, longer periodic components, indicating slower periodic activity, and differences in feature location, suggesting alterations in motility at areas of pathology as compared to patients without villous atrophy. Improvements in the quantitative analysis of VCE imaging in celiac patients is important to detect pathology in suspected patients, so that biopsies can be obtained from pertinent regions of the small intestinal mucosa. Improvements are also necessary so that patients with celiac disease can be monitored to evaluate the progress of mucosal healing after onset of treatment.

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