Validation of SmartPill® wireless motility capsule for gastrointestinal transit time: Intra‐subject variability, software accuracy and comparison with video capsule endoscopy

• Published in: Neurogastroenterology and motility Vol. 29; no. 10; pp. 1 - 9
• Main Authors: Diaz Tartera, H. O., Webb, D.‐L., Al‐Saffar, A. Kh, Halim, M. A., Lindberg, G., Sangfelt, P., Hellström, P. M.
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01-10-2017
• Subjects: Accuracy; Adult; Aged; Capsule Endoscopy - instrumentation; Colon; Computer programs; constipation; Data processing; Endoscopy; Female; Food intake; Gastric emptying; Gastric motility; gastrointestinal dysmotility; Gastrointestinal Motility; Gastrointestinal Transit; gastroparesis; Humans; Male; Medicin och hälsovetenskap; Middle Aged; Motility; pH effects; Reproducibility of Results; Small intestine; Software; Young Adult; constipation; motility; gastrointestinal dysmotility; gastroparesis
• ISSN: 1350-1925; 1365-2982; 1365-2982
• DOI: 10.1111/nmo.13107

Background
There is interest in ultimately combining endoscopy and motility assessments. Gastric emptying (GET), small bowel (SBTT), colon (CTT) and whole gut transit (WGTT) times are conveniently obtained by SmartPill® wireless motility capsule (WMC) that records luminal pH, temperature and pressure. Reproducibility within same subjects and accuracy of software derived times (MotiliGI®) were investigated for diagnostic application. GET and SBTT were separately measured using video capsule endoscopy (VCE). The aim of this investigation was to assess same subject reproducibility of WMC, accuracy of software derived transit times and relate to Pillcam® SB (small bowel) VCE motility data.
Methods
Seventy three healthy adults ingested a 260 kcal mixed meal followed by WMC tests. Food intake was permitted after 6 hours. Regional transit data was obtained for GET, SBTT and CTT, the sum yielding WGTT. Nineteen subjects repeated WMC tests 2 or 4 weeks later; a separate 70 underwent VCE while fasted.
Key Results
Visually derived data from WMC yielded GET 3.46±0.27, SBTT 5.15±0.21, CTT 20.76±1.19 and WGTT 29.53±1.28 hours (mean±SEM). Pearson's correlation coefficients (r) against software derived results were: GET 0.78 (P<.0001), SBTT 0.28 (P<.05), CTT 0.96 (P<.0001), WGTT 0.99 (P<.0001). VCE yielded lower GET (0.71±0.08 hours) and SBTT (4.15±0.13 hours).
Conclusions and Inferences
GET, SBTT, CTT and WGTT obtained by WMC are commensurate with literature values, including by other methods. Visually and software derived transit times have strongest correlations for CTT and WGTT. WMC yields longer GET and SBTT than VCE, perhaps due to meal related effects on motility.
Gastric emptying time and small bowel transit time for SmartPill® WMC (mixed meal) and Pillcam® SB VCE (fasted) (mean +/‐ SEM).