title: Three-dimensional representation software as image enhancement tool in small-bowel capsule endoscopy: a feasibility study.
abstract: BACKGROUND
  Three-dimensional imaging in capsule endoscopy is not currently feasible due to hardware limitations. However, software algorithms that enable three-dimensional reconstruction in capsule endoscopy are available.
  
  
  METHODS
  Feasibility study. A phantom was designed to test the accuracy of three-dimensional reconstruction. Thereafter, 192 small-bowel capsule endoscopy images (of vascular: 50; inflammatory: 73; protruding structures: 69) were reviewed with the aid of a purpose-built three-dimensional reconstruction software. Seven endoscopists rated visualisation improved or non-improved. Subgroup analyses performed for diagnostic category, diagnosis, image surface morphology and colour and SBCE equipment used (PillCam(®) vs. MiroCam(®)).
  
  
  RESULTS
  Overall, phantom experiments showed that the three-dimensional reconstruction software was accurate at 90% of red, 70% of yellow and 45% of white phantom models. Enhanced visualisation for 56% of vascular, 23% of inflammatory and <10% of protruding structures was noted (P=0.007, 0.172 and 0.008, respectively). Furthermore, three-dimensional software application enhanced 53.7% of red, 21.8% of white, 17.3% of red and white, and 9.2% of images of lesions with colour similar to that of the surrounding mucosa, P<0.0001.
  
  
  CONCLUSIONS
  Application of a three-dimensional reconstruction software in capsule endoscopy leads to image enhancement for a significant proportion of vascular, but less so for inflammatory and protruding lesions. Until optics technology allows hardware-enabled three-dimensional reconstruction, it seems a plausible alternative.
authors.affiliation: Centre for Liver & Digestive Disorders, The Royal Infirmary of Edinburgh, Scotland, UK. Electronic address: akoulaouzidis@hotmail.com.
authors.forename: Anastasios
authors.initials: A
authors.lastname: Koulaouzidis
authors.forename: Alexandros
authors.initials: A
authors.lastname: Karargyris
authors.forename: Emanuele
authors.initials: E
authors.lastname: Rondonotti
authors.forename: Colin L
authors.initials: CL
authors.lastname: Noble
authors.forename: Sarah
authors.initials: S
authors.lastname: Douglas
authors.forename: Efstratios
authors.initials: E
authors.lastname: Alexandridis
authors.forename: Ali M
authors.initials: AM
authors.lastname: Zahid
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Bathgate
authors.forename: Ken C
authors.initials: KC
authors.lastname: Trimble
authors.forename: John N
authors.initials: JN
authors.lastname: Plevris
mesh_terms: D000465:Algorithms; D053704:Capsule Endoscopy / Q000295:instrumentation*; D004867:Equipment Design; D005240:Feasibility Studies; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis*; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D007421:Intestine, Small / Q000473:pathology*; D019047:Phantoms, Imaging; D015203:Reproducibility of Results; D012984:Software
keywords: Capsule endoscopy; Enhancement; Feasibility; Inflammatory; Polyps; Reconstruction; Small-bowel; Software; Three-dimensional; Vascular