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

Diana E. Yung; Pedro Boal Carvalho; Andry Giannakou; Uri Kopylov; Bruno Rosa; Emanuele Rondonotti; Ervin Toth; John N. Plevris; Anastasios Koulaouzidis

doi:10.1055/s-0042-122015

Endoscopy, Table of Contents

Endoscopy 2017; 49(03): 258-269
DOI: 10.1055/s-0042-122015

Review

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

Authors

Diana E. Yung

¹Centre for Liver and Digestive Disorders, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom
Pedro Boal Carvalho

²Gastroenterology Department, Hospital Senhora da Oliveira, Guimarães, Portugal
Andry Giannakou

³Faculty of Economics and Management, Open University of Cyprus, Nicosia, Cyprus
Uri Kopylov

⁴Department of Gastroenterology, Sheba Medical Center, Tel Hashomer, and Sackler School of Medicine, Tel Aviv University, Israel
Bruno Rosa

²Gastroenterology Department, Hospital Senhora da Oliveira, Guimarães, Portugal
Emanuele Rondonotti

⁵Gastroenterology Unit, Valduce Hospital, Como, Italy
Ervin Toth

⁶Department of Gastroenterology, Skåne University Hospital, Lund University, Malmö, Sweden
John N. Plevris

¹Centre for Liver and Digestive Disorders, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom
Anastasios Koulaouzidis

¹Centre for Liver and Digestive Disorders, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom

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.

Full Text

References

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