Diagnostic Accuracy of Tethered Control and Magnetically Controlled Capsule Endoscopy in Esophageal Diseases: A Meta-analysis.

Abstract

Background: Magnetic-controlled capsule endoscopy (MCCE), primarily represented by the ANKON and Mirocam capsule systems, uses tethered control and magnetic control methods, respectively, for esophageal examination. However, due to variations in results and capsule types across studies, conclusions regarding its diagnostic accuracy remain inconsistent.

Methods: A systematic search was conducted in PubMed, Embase, Web of Science, and Wanfang databases, covering studies published up to November 4, 2024. To assess the diagnostic accuracy of MCCE for esophageal diseases, we used a bivariate random-effects model in Stata 15.0, synthesizing estimates for sensitivity, specificity, likelihood ratios (LR), diagnostic odds ratio (DOR), and generating a summary receiver operating characteristic (SROC) curve with the corresponding area under the curve (AUC). Where appropriate, sensitivity analyses were performed to assess the stability of the results, and meta-regression was conducted to investigate potential sources of heterogeneity.

Results: Ten studies with 1155 patients were analyzed. The pooled sensitivity and specificity of MCCE for diagnosing esophageal diseases were 0.95 (95% CI: 0.92-0.97) and 0.97 (95% CI: 0.92-0.99), respectively. The diagnostic odds ratio (DOR) was 663.00 (95% CI: 157.24-2795.56), and the area under the curve (AUC) was 0.99. The pooled positive likelihood ratio (PLR) and negative likelihood ratio (NLR) were 32.72 (95% CI: 11.94-89.71) and 0.05 (95% CI: 0.03-0.09), respectively.

Conclusions: This meta-analysis highlights the high sensitivity, specificity, and accuracy of MCCE in diagnosing esophageal diseases, suggesting it as a promising alternative for patients unable to undergo esophagogastroduodenoscopy. However, limited studies and observed heterogeneity may restrict its routine use, emphasizing the need for large-scale, multicenter prospective studies.