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Identifying Celiac Disease Using Quantitative Analysis of Videocapsule Endoscopy Imaging


Columbia University--Photo: CC/Stijn Debrouwere

Celiac.com 06/23/2010 - A team of researchers evaluated the possibility of diagnosing celiac disease using quantitative analysis of videocapsule endoscopy images.

The team included Edward J. Ciaccioa, Christina A. Tennysonb, Suzanne K. Lewisb, Suneet, Krishnareddy, Govind Bhagat, and Peter H.R. Green. They are variously associated with the Department of Pharmacology, Department of Medicine,  Department of Pathology, Columbia University College of Physicians and Surgeons in New York.

Images taken with videocapsule endoscopy can be useful for diagnosing celiac disease, but their interpretation is highly subjective. Quantitative disease markers might help to determine the degree of villous atrophy and efficacy of treatment.

The team gathered capsule endoscopy images from a group of 11 celiac patients with small bowel pathology, and from a group of 10 control patients.

Images had a resolution of 576×576 pixels, with 256 grayscale tones, and a frame-rate of 2 s−1.  The team measured over 10×10 pixel sub-images for pixel brightness and image texture. They then averaged the results for for 56×56 sub-images per frame.

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For each patient, the team took measurements at from five locations in the proximal to distal small intestine. At each location, they figured measurements using 200 consecutive image frames (100 s).

For classification with a nonlinear discriminant function, they computed mean frame-to-frame pixel brightness, image texture, periodicity in brightness, and estimated wall motion or intestinal motility.

By pooling the data, the team found that images from the celiac group showed greater texture than did images from control group (p < 0.001).

Images from the celiac disease group exhibited more frame-to-frame brightness variation as well (p = 0.032). Celiac patients showed longer dominant period of brightness in celiacs (p = 0.001), which may indicate reduced motility.

Markers for three-dimensional nonlinear classification of celiacs versus controls showed sensitivity of 92.7% and specificity of 93.5%. Both celiac patients and control subjects showed an approximately linear association between dominant period and small intestinal transit time (r2 = 0.42 and r2 =0 .55, respectively).

The results show that videocapsule images can be used to reveal villous atrophy throughout the small intestine, and to distinguish individuals with celiac disease from individuals without mucosal atrophy.

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1 Response:

 
Jay
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said this on
28 Jun 2010 7:25:53 PM PDT
My own diagnosis was by a deep balloon endoscopy sample that confirmed and is seen by the pill cam. The pill cam photo's clearly show the damage to the villa and the tell tale signs of celiac disease but the balloon endoscopy would not reach to that area because of the turning of the lower intestines. The biopsy confirmed the pill cam, and I've lived gluten-free since with outstanding results.




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Those labs do not look like celiac tests. The first three MIGHT just be measuring total antibody levels of the three different classes, but on the very right it has IgA Serp (Serp cut off?) and I don't know what the Serp is referring to. The first column is the test name, the second column your value, the third column the units of measure, the fourth column the normal range. The first one is a tiny bit low, all the rest in the normal range.

Since this post is going around again, I thought I would add my recent experience at Rudy's. The staff was very helpful and accommodating. I ordered my family's food first put it on a tray and then ordered mine separately. I ordered only chicken and turkey. The staff changed gloves and used a new cutting board and knife. My server washed his hands, wiped down the scale and put my meat separately into a tray. I washed my hands before I ate. I did not eat any of the side and brought my own fruit to go with it. Since I don't get immediate symptoms, I can't tell you if that was enough. But, their meat (except the pork - maybe ) is gluten free. I think I did everything I can to avoid CC and the staff was extremely helpful . This is the only restaurant I have eaten at in 4 months if that tells you anything. I love Rudy's!!!

I got my script from the doc... it's for total IGA and TTG-IGA. Guess that's a good start? It also says "fasting" on the requisition, do I really need to be?

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