Assessment of colorectal length using the electromagnetic capsule tracking system: a comparative validation study in healthy subjects

AIM: We aimed to determine colorectal length with the 3D-Transit system by describing a 'centerline' of capsule movement and compare it to known anatomy, as determined by magnetic resonance imaging (MRI). Further, we aimed to test the day-to-day variation of colorectal length assessed with the system.

METHOD: The 3D-Transit system consists of electromagnetic capsules that can be tracked as they traverse the gastrointestinal tract. 25 healthy subjects were examined with both 3D-Transit and MRI. Another 21 healthy subjects were examined with 3D-Transit on two consecutive days.

RESULTS: Computation of colorectal length from capsule passage was possible in 60 of the 67 3D-Transit recordings. Length of the colorectum measured with MRI and 3D-Transit was respectively 95 cm (75-153 cm) and 99 cm (77-147 cm), P = 0.15. Coefficient of variation (CV) between MRI and 3D-Transit was 7.8%. Apart from the cecum / ascending colon being 26% (P = 0.002) shorter on MRI, there were no other differences in total or segmental colorectal lengths between methods (all P > 0.05). Length of the colorectum measured with 3D-Transit on two consecutive days was 102 cm (73-119 cm) and 103 cm (75-123 cm), P = 0.67. CV between days was 7.3%.

CONCLUSIONS: The 3D-Transit system allows accurate and reliable determination of colorectal length compared to MRI derived colorectal length and between days. Antegrade or retrograde capsule movement relative to this centerline, as well as the length and speed of movements may be determined by future studies to allow better classification and treatment in patients with dysmotility. This article is protected by copyright. All rights reserved.