title: Improved visibility of lesions of the small intestine via capsule endoscopy with computed virtual chromoendoscopy.
abstract: BACKGROUND
  We can now enhance video capsule endoscopy (CE) images in real time by means of a flexible spectral imaging color enhancement (FICE) digital processing system. Reports on the clinical usefulness of this system are few.
  
  
  OBJECTIVE
  To clarify whether visualization of lesions of the small intestine is improved by FICE image analysis.
  
  
  METHODS
  A retrospective study.
  
  
  METHODS
  Academic medical center.
  
  
  METHODS
  Five physicians compared FICE images with corresponding conventional images of 145 lesions obtained from 122 patients who underwent video CE at our hospital. The lesions were classified as angioectasia (n=23), erosion/ulceration (n=45), or tumor (n=75), and 3 different sets of FICE images were viewed (ie, at 3 different wavelength settings). Physicians rated the visibility of the lesions on FICE images as follows: +2 (improved visibility), +1 (somewhat improved visibility), 0 (visibility equivalent to that of conventional video CE visibility), -1 (somewhat decreased visibility), and -2 (decreased visibility). Scores for each lesion were totaled (per FICE setting) and evaluated. Intraobserver agreement was also examined.
  
  
  RESULTS
  With FICE setting 1 (red 595 nm, green 540 nm, blue 535 nm), improvement was achieved for 87% (20/23) of angioectasia images, 53.3% (26/47) of erosion/ulceration images, and 25.3% (19/75) of tumor images. With setting 2 (red 420 nm, green, 520 nm, blue 530 nm), improvement was achieved for 87% (20/23), 25.5% (12/47), and 20.0% (15/75), respectively. With setting 3, only equivalence was achieved. Intraobserver agreement was good to satisfactory at 5.4 or higher.
  
  
  CONCLUSIONS
  Single-center study.
  
  
  CONCLUSIONS
  CE-FICE improves visibility of small-bowel angioectasia, erosion/ulceration, and tumor.
authors.affiliation: Department of Medicine and Molecular Science, Graduate School of Biomedical Science, Hiroshima University, and Department of Endoscopy, Hiroshima University Hospital, Hiroshima, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Imagawa
authors.forename: Shiro
authors.initials: S
authors.lastname: Oka
authors.forename: Shinji
authors.initials: S
authors.lastname: Tanaka
authors.forename: Ikue
authors.initials: I
authors.lastname: Noda
authors.forename: Makoto
authors.initials: M
authors.lastname: Higashiyama
authors.forename: Youji
authors.initials: Y
authors.lastname: Sanomura
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Shishido
authors.forename: Shigeto
authors.initials: S
authors.lastname: Yoshida
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Chayama
mesh_terms: D053704:Capsule Endoscopy / Q000379:methods*; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007091:Image Processing, Computer-Assisted; D007410:Intestinal Diseases / Q000175:diagnosis*; D007421:Intestine, Small; D012372:ROC Curve; D012189:Retrospective Studies