Efficacy of flexible spectral imaging color enhancement on the detection of small intestinal diseases by capsule endoscopy.

Objective: The aim of this study was to estimate the efficacy of flexible spectral imaging color enhancement (FICE) on the detection of small intestinal diseases by capsule endoscopy (CE).

Methods: Six individuals without significant lesions and 18 patients with following diseases were selected: four tumors, five angioectasias, seven ulcerative diseases, one ulcerative lesion and tumor and one ulcerative lesion and angioectasia. Three endoscopists reviewed all CE videos on standard and three types of FICE modes and compared their sensitivity and specificity for detection of small intestinal diseases.

Results: The overall sensitivity of CE was 94.4% at standard mode, 90.7% at FICE channel (Ch) 1, 87.0% at FICE Ch 2 and 87.0% at FICE Ch 3 and the overall specificity of CE was 66.7%, 55.6%, 77.8% and 66.7%, respectively, per patient. There was no significant difference between the standard and each FICE mode. In per-lesion analysis, FICE Ch 1 detected more angioectasias and ulcerative lesions than the standard mode (angioectasia, 25.7 vs 21.0, P = 0.005; ulcerative lesions, 19.3 vs 14.0, P = 0.06). However, FICE Ch 1 missed more tumors than the standard mode (4.3 vs 10.0, P = 0.003).

Conclusions: Although FICE Ch 1 is better in detecting angioectasias and ulcerative lesions and worse in tumors or polyps than the standard mode, the patient-based sensitivity and specificity of small intestinal diseases are not different between standard and each FICE mode. Further experiences with and improvement of FICE are required.