Feasibility Study of a New MRI Mini-Capsule Device to Measure Whole Gut Transit Time in Pediatric Constipation

Sharif, Hayfa; Abrehart, Nichola; Hoad, Caroline; Murray, Kathryn; Perkins, Alan; Smith, Murray; Gowland, Penny; Spiller, Robin; Harris, Roy; Kirkham, Sian; Loganathan, Sabarinathan; Papadopoulos, Michalis; Frost, Kate; Young Persons Advisory Group; Devadason, David; Marciani, Luca

Abstract

Objective: In England, 27,500 children are referred annually to hospital with constipation. An objective measure of whole gut transit time (WGTT) could aid management. The current standard WGTT assessment, the X-ray radiopaque marker (ROM) test, gives poor definition of colonic anatomy and the radiation dose required is undesirable in children. Our objective was to develop an alternative MRI WGTT measure to the X-ray ROM test and to demonstrate its initial feasibility in pediatric constipation.

Methods: With the Nottingham Young Person’s Advisory Group (YPAG) we developed a small (8mm×4mm), inert polypropylene capsule shell filled with MRI-visible fat emulsion. The capsule can be imaged using MRI fat and water in-phase and out of phase imaging. Sixteen patients with constipation and 19 healthy participants aged 7-18 years old were recruited. Following a common ROM protocol, the participants swallowed 24 mini-capsules each day for 3 days and were imaged on day 4 and 7 using MRI. The number of successful studies (feasibility) and WGTT were assessed. Participants’ EQ-VAS were also collected and compared between the day before the taking the first set of mini-capsules to the day after the last MRI study day.

Results: The mini-capsules were imaged successfully in the colon of all participants. The WGTT was 78±35 hours (mean±SD) for patients, and 36±16 hours, P < 0.0001 for healthy controls. Carrying out the procedures did not change the EQ-VAS scores before and after the procedures.

Conclusions: MAGIC (Magnetic Resonance Imaging in Pediatric Constipation) was a first-in-child feasibility study of a new medical device to measure WGTT in pediatric constipation using MRI. The study showed that the new method is feasible and was well tolerated.

Citation

Sharif, H., Abrehart, N., Hoad, C., Murray, K., Perkins, A., Smith, M., …Marciani, L. (2020). Feasibility Study of a New MRI Mini-Capsule Device to Measure Whole Gut Transit Time in Pediatric Constipation. Journal of Pediatric Gastroenterology and Nutrition, 71(5), 604-611. https://doi.org/10.1097/MPG.0000000000002910

• Journal Article Type: Article
• Acceptance Date: Jul 29, 2020
• Online Publication Date: Aug 17, 2020
• Publication Date: 2020-11
• Deposit Date: Aug 6, 2020
• Publicly Available Date: Aug 18, 2021
• Journal: Journal of Pediatric Gastroenterology and Nutrition
• Print ISSN: 0277-2116
• Electronic ISSN: 1536-4801
• Publisher: Lippincott, Williams & Wilkins
• Peer Reviewed: Peer Reviewed
• Volume: 71
• Issue: 5
• Pages: 604-611
• DOI: https://doi.org/10.1097/MPG.0000000000002910
• Public URL: https://nottingham-repository.worktribe.com/output/4813649
• Publisher URL: https://journals.lww.com/jpgn/Fulltext/2020/11000/Feasibility_Study_of_a_New_Magnetic_Resonance.6.aspx