Download PDF
Endoscopy 2017; 49(03): 258-269
DOI: 10.1055/s-0042-122015
Review
© Georg Thieme Verlag KG Stuttgart · New York

Clinical validity of flexible spectral imaging color enhancement (FICE) in small-bowel capsule endoscopy: a systematic review and meta-analysis

Diana E. Yung
1   Centre for Liver and Digestive Disorders, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom
,
Pedro Boal Carvalho
2   Gastroenterology Department, Hospital Senhora da Oliveira, Guimarães, Portugal
,
Andry Giannakou
3   Faculty of Economics and Management, Open University of Cyprus, Nicosia, Cyprus
,
Uri Kopylov
4   Department of Gastroenterology, Sheba Medical Center, Tel Hashomer, and Sackler School of Medicine, Tel Aviv University, Israel
,
Bruno Rosa
2   Gastroenterology Department, Hospital Senhora da Oliveira, Guimarães, Portugal
,
Emanuele Rondonotti
5   Gastroenterology Unit, Valduce Hospital, Como, Italy
,
Ervin Toth
6   Department of Gastroenterology, Skåne University Hospital, Lund University, Malmö, Sweden
,
John N. Plevris
1   Centre for Liver and Digestive Disorders, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom
,
Anastasios Koulaouzidis
1   Centre for Liver and Digestive Disorders, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom
› Author Affiliations
Further Information

Publication History

Publication Date:
25 January 2017 (online)

Also available at
    Permissions and Reprints

Abstract

Patients and methods A comprehensive literature search was conducted. We measured pooled rate of lesion visualization improvement and improvement in lesion detection comparing FICE settings 1 – 3 and WLE, for angioectasias and ulcers/erosions. Pooled results were derived using the random-effects model because of high heterogeneity as measured by I 2. Repeated-measures analysis of variance (ANOVA) was used to measure differences in lesion detection between WLE and the three FICE modes.

Results 13 studies were analyzed. All studies used the PillCam SB 1 and/or SB 2 devices. Most used experienced readers. Improvement in delineation had been investigated in 4 studies; in the 3 studies entered into the meta-analysis, using FICE setting 1, 89 % of angioectasias and 45 % of ulcer/erosions were considered to show improved delineation. For FICE settings 2 and 3, small proportions of images showed improved delineation. Heterogeneity of studies was high with I 2 > 90 % in 4/6 analyses. Lesion detection had been investigated in 10 studies; meta-analysis included 5 studies. Lesion detection did not differ significantly between any of the FICE modes and WLE.

Conclusions Overall, the use of the three FICE modes did not significantly improve delineation or detection rate in SBCE. In pigmented lesions, FICE setting 1 performed better in lesion delineation and detection.

 

  • References

  • 1 Koulaouzidis A, Rondonotti E, Karargyris A. Small-bowel capsule endoscopy: A ten-point contemporary review. World J Gastroenterol 2013; 19: 3726-3746
    CrossrefPubMedGoogle Scholar
  • 2 Pennazio M, Spada C, Eliakim R. et al. Small-bowel capsule endoscopy and device-assisted enteroscopy for diagnosis and treatment of small-bowel disorders: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline. Endoscopy 2015; 47: 352-376
    Article in Thieme ConnectPubMedGoogle Scholar
  • 3 Zheng Y, Hawkins L, Wolff J. et al. Detection of lesions during capsule endoscopy: physician performance is disappointing. Am J Gastroenterol 2012; 107: 554-560
    CrossrefPubMedGoogle Scholar
  • 4 Rondonotti E, Herrerias JM, Pennazio M. et al. Complications, limitations, and failures of capsule endoscopy: A review of 733 cases. Gastrointest Endosc 2005; 62: 712-716
    CrossrefPubMedGoogle Scholar
  • 5 Chong AKH, Chin BWK, Meredith CG. Clinically significant small-bowel pathology identified by double-balloon enteroscopy but missed by capsule endoscopy. Gastrointest Endosc 2006; 64: 445-449
    CrossrefPubMedGoogle Scholar
  • 6 Postgate A, Despott E, Burling D. et al. Significant small-bowel lesions detected by alternative diagnostic modalities after negative capsule endoscopy. Gastrointest Endosc 2008; 68: 1209-1214
    CrossrefPubMedGoogle Scholar
  • 7 Zagorowicz ES, Pietrzak AM, Wronska E. et al. Small bowel tumors detected and missed during capsule endoscopy: Single center experience. World J Gastroenterol 2013; 19: 9043-9048
    CrossrefPubMedGoogle Scholar
  • 8 ASGE Technology Committee Wang A, Banerjee S, Barth BA. et al. Wireless capsule endoscopy. Gastrointest Endosc; 2013 78. 805-815
    PubMedGoogle Scholar
  • 9 Selby WS, Prakoso E. The inability to visualize the ampulla of Vater is an inherent limitation of capsule endoscopy. Eur J Gastroenterol Hepatol 2011; 23: 101-103
    CrossrefPubMedGoogle Scholar
  • 10 Koulaouzidis A, Iakovidis DK, Karargyris A. et al. Optimizing lesion detection in small-bowel capsule endoscopy: from present problems to future solutions. Expert Rec Gastroenterol Hepatol 2015; 9: 217-235
    PubMedGoogle Scholar
  • 11 Manfredi MA, Abu Dayyeh BK, Bhat YM. et al. Electronic chromoendoscopy. Gastrointest Endosc 2015; 81: 249-261
    CrossrefPubMedGoogle Scholar
  • 12 Mishkin DS, Chuttani R, Croffie J. et al. ASGE Technology Status Evaluation Report: Wireless capsule endoscopy. Gastrointest Endosc 2006; 63: 539-545
    CrossrefPubMedGoogle Scholar
  • 13 Imagawa H, Oka S, Tanaka S. et al. Improved visibility of lesions of the small intestine via capsule endoscopy with computed virtual chromoendoscopy. Gastrointest Endosc 2011; 73: 299-306
    CrossrefPubMedGoogle Scholar
  • 14 Neumann H, Fry LC, Bellutti M. et al. Double-balloon enteroscopy-assisted virtual chromoendoscopy for small-bowel disorders: a case series. Endoscopy 2009; 41: 468-471
    Article in Thieme ConnectPubMedGoogle Scholar
  • 15 Higgins JPT, Thompson SG. Quantifying heterogeneity in a meta-analysis. Stat Med 2002; 21: 1539-1558
    CrossrefPubMedGoogle Scholar
  • 16 Misangyi VF, LePine JA, Algina J. et al. The adequacy of repeated-measures regression for multilevel research: comparisons with repeated-measures ANOVA, multivariate repeated-measures ANOVA, and multilevel modeling across various multilevel research designs. Organ Res Methods 2006; 9: 5-28
    CrossrefPubMedGoogle Scholar
  • 17 Whiting PF, Rutjes AWS, Westwood ME. et al. Quadas-2: A revised tool for the quality assessment of diagnostic accuracy studies. Ann Intern Med 2011; 155: 529-536
    CrossrefPubMedGoogle Scholar
  • 18 Rimbaş M, Negreanu L, Ciobanu L. et al. Is virtual chromoendoscopy useful in the evaluation of subtle ulcerative small-bowel lesions detected by video capsule endoscopy?. Endosc Int Open 2015; 3: E615-620
    Article in Thieme ConnectPubMedGoogle Scholar
  • 19 Maeda M, Hiraishi H. Efficacy of video capsule endoscopy with flexible spectral imaging color enhancement at setting 3 for differential diagnosis of red spots in the small bowel. Dig Endosc 2014; 26: 228-231
    CrossrefPubMedGoogle Scholar
  • 20 Pohl J, Aschmoneit I, Schuhmann S. et al. Computed image modification for enhancement of small-bowel surface structures at video capsule endoscopy. Endoscopy 2010; 42: 490-492
    Article in Thieme ConnectPubMedGoogle Scholar
  • 21 Krystallis C, Koulaouzidis A, Douglas S. et al. Chromoendoscopy in small bowel capsule endoscopy: Blue mode or Fuji Intelligent Colour Enhancement?. Dig Liver Dis 2011; 43: 953-957
    CrossrefPubMedGoogle Scholar
  • 22 Sato Y, Sagawa T, Hirakawa M. et al. Clinical utility of capsule endoscopy with flexible spectral imaging color enhacement for diagnosis of small bowel lesions. Endosc Int Open 2014; 2: E80-87
    Article in Thieme ConnectPubMedGoogle Scholar
  • 23 Cotter J. Virtual chromoendoscopy in small bowel capsule endoscopy: New light or a cast of shadow?. World J Gastrointest Endosc 2014; 6: 359-365
    CrossrefPubMedGoogle Scholar
  • 24 Imagawa H, Oka S, Tanaka S. et al. Improved detectability of small-bowel lesions via capsule endoscopy with computed virtual chromoendoscopy: A pilot study. Scand J Gastroenterol 2011; 46: 1133-1137
    CrossrefPubMedGoogle Scholar
  • 25 Duque G, Almeida N, Figueiredo P. et al. Virtual chromoendoscopy can be a useful software tool in capsule endoscopy. Rev Esp Enfermedades Dig 2012; 104: 231-236
    PubMedGoogle Scholar
  • 26 Kobayashi Y, Watabe H, Yamada A. et al. Efficacy of flexible spectral imaging color enhancement on the detection of small intestinal diseases by capsule endoscopy. J Dig Dis 2012; 13: 614-620
    CrossrefPubMedGoogle Scholar
  • 27 Matsumura T, Arai M, Sato T. et al. Efficacy of computed image modification of capsule endoscopy in patients with obscure gastrointestinal bleeding. World J Gastrointest Endosc 2012; 4: 421-428
    CrossrefPubMedGoogle Scholar
  • 28 Sakai E, Endo H, Kato S. et al. Capsule endoscopy with flexible spectral imaging color enhancement reduces the bile pigment effect and improves the detectability of small bowel lesions. BMC Gastroenterol 2012; 12: 83
    CrossrefPubMedGoogle Scholar
  • 29 Konishi M, Shibuya T, Mori H. et al. Usefulness of flexible spectral imaging color enhancement for the detection and diagnosis of small intestinal lesions found by capsule endoscopy. Scand J Gastroenterol 2014; 49: 501-505
    CrossrefPubMedGoogle Scholar
  • 30 Boal Carvalho P, Magalhães J, Dias de Castro F. et al. Virtual chromoendoscopy improves the diagnostic yield of small bowel capsule endoscopy in obscure gastrointestinal bleeding. Dig Liver Dis 2016; 48: 172-175
    CrossrefPubMedGoogle Scholar
  • 31 Gupta T, Ibrahim M, Deviere J. et al. Evaluation of Fujinon intelligent chromo endoscopy-assisted capsule endoscopy in patients with obscure gastroenterology bleeding. World J Gastroenterol 2011; 17: 4590-4595
    CrossrefPubMedGoogle Scholar
  • 32 Dias de Castro F, Magalhães J, Boal Carvalho P. et al. Improving diagnostic yield in obscure gastrointestinal bleeding – how virtual chromoendoscopy may be the answer. Eur J Gastroenterol Hepatol 2015; 27: 735-740
    CrossrefPubMedGoogle Scholar
  • 33 Saurin JC, Delvaux M, Gaudin JL. et al. Diagnostic value of endoscopic capsule in patients with obscure digestive bleeding: Blinded comparison with video push-enteroscopy. Endoscopy 2003; 35: 576-584
    Article in Thieme ConnectPubMedGoogle Scholar
  • 34 Cass OW. Is half-knowledge worse than ignorance?. Gastrointest Endosc 2006; 64: 542-543
    CrossrefPubMedGoogle Scholar
  • 35 Ciuti G, Menciassi A, Dario P. Capsule endoscopy: From current achievements to open challenges. IEEE Rev Biomed Eng 2011; 4: 59-72
    CrossrefPubMedGoogle Scholar
  • 36 Sliker LJ, Ciuti G. Flexible and capsule endoscopy for screening, diagnosis and treatment. Expert Rev Med Devices 2014; 11: 649-666
    CrossrefPubMedGoogle Scholar
  • 37 Hale M, McAlindon ME. Capsule endoscopy as a panenteric diagnostic tool. Br J Surg 2014; 101: 148-149
    CrossrefPubMedGoogle Scholar
  • 38 Spada C, Hassan C, Costamagna G. Virtual chromoendoscopy: Will it play a role in capsule endoscopy?. Dig Liver Dis 2011; 43: 927-928
    CrossrefPubMedGoogle Scholar
  • 39 Girelli CM, Porta P, Colombo E. et al. Development of a novel index to discriminate bulge from mass on small-bowel capsule endoscopy. Gastrointest Endosc 2011; 74: 1067-1074
    CrossrefPubMedGoogle Scholar
  • 40 Rondonotti E, Koulaouzidis A, Karargyris A. et al. Utility of 3-dimensional image reconstruction in the diagnosis of small-bowel masses in capsule endoscopy (with video). Gastrointest Endosc 2015; 80: 642-651
    PubMedGoogle Scholar
  • 41 Green DG. The contrast sensitivity of the colour mechanisms of the human eye. J Physiol 1968; 196: 415-429
    CrossrefPubMedGoogle Scholar
  • 42 Hill RA, Barton RA. Psychology: red enhances human performance in contests. Nature 2005; 435: 293
    CrossrefPubMedGoogle Scholar
  • 43 Ilie A, Ioan S, Zagrean L. et al. Better to be red than blue in virtual competition. Cyber Psychol Behav 2008; 11: 375-377
    CrossrefPubMedGoogle Scholar
  • 44 Rimbaş M, Zahiu DCM, Voiosu AM. et al. Usefulness of virtual chromoendoscopy in the evaluation of subtle small bowel ulcerative lesions by endoscopists with no experience in videocapsule. Endosc Int Open 2016; 4: E508-514
    Article in Thieme ConnectPubMedGoogle Scholar
  • 45 Ryu CB, Song J-Y, Lee MS. et al. Mo1670 Does capsule endoscopy with alice improves visibility of small bowel lesions?. Gastrointest Endosc 2013; 77: AB466
    PubMedGoogle Scholar
  • 46 Koulaouzidis A, Smirnidis A, Douglas S. et al. QuickView in small-bowel capsule endoscopy is useful in certain clinical settings, but QuickView with Blue Mode is of no additional benefit. Eur J Gastroenterol Hepatol 2012; 24: 1099-1104
    CrossrefPubMedGoogle Scholar
  • 47 Abdelaal UM, Morita E, Nouda S. et al. Blue mode imaging may improve the detection and visualization of small-bowel lesions: A capsule endoscopy study. Saudi J Gastroenterol 2015; 21: 418-422
    CrossrefPubMedGoogle Scholar
  • 48 Koulaouzidis A, Douglas S, Plevris JN. Blue mode does not offer any benefit over white light when calculating Lewis score in small-bowel capsule endoscopy. World J Gastrointest Endosc 2012; 4: 33-37
    CrossrefPubMedGoogle Scholar
  • 49 Aihara H, Ikeda K, Tajiri H. Image-enhanced capsule endoscopy based on the diagnosis of vascularity when using a new type of capsule. Gastrointest Endosc 2011; 73: 1274-1279
    CrossrefPubMedGoogle Scholar