title: Usefulness of flexible spectral imaging color enhancement for the detection and diagnosis of small intestinal lesions found by capsule endoscopy.
abstract: OBJECTIVE
  Capsule endoscopy (CE) is an established technique for the detection and diagnosis of obscure gastrointestinal bleeding (OGIB). Flexible spectral imaging color enhancement (FICE) is a software feature of RAPID 6.5. This study assessed the value of FICE for accurate identification of red lesions during CE.
  
  
  METHODS
  We randomly selected 10 patients who underwent CE for OGIB at Juntendo University. The CE images were read by five endoscopists. Small bowel videos, which were recorded by regular CE devices (PillCam SB2, Given Imaging), were evaluated on RAPID 6.5. We standardized the reading condition to a dual view, at a speed of 20 frames/s in manual mode. This interpreted FICE-CE images obtained at settings 1-3. Both conventional and FICE images were read at random. We defined a conventional image as standard and investigated the potential of FICE in detecting small intestinal lesions by the Steel-Dwass test.
  
  
  RESULTS
  We considered that conventional images represented baseline (100). On this basis, detection rates for FICE images were as follows: FICE1 = 266.4 ± 33.1 (p < 0.0001); FICE2 = 255.4 ± 25.6 (p < 0.0001); and FICE3 = 117.0 ± 12.3 (p = 0.9447). Detection rates using FICE1 and FICE2 images were significantly higher than conventional CE images. FICE1 and FICE2 were more useful in detecting erosions than conventional CE (p < 0.0001) and FICE3 (p < 0.0001).
  
  
  CONCLUSIONS
  FICE-CE has a high level of visibility by transparentizing bile or enhancing the color difference associated with reddish mucosa. We found that FICE-CE images were useful in the diagnosing of small intestinal lesions.
authors.affiliation: Department of Gastroenterology, Juntendo University School of Medicine , Tokyo , Japan.
authors.forename: Masae
authors.initials: M
authors.lastname: Konishi
authors.forename: Tomoyoshi
authors.initials: T
authors.lastname: Shibuya
authors.forename: Hiroki
authors.initials: H
authors.lastname: Mori
authors.forename: Erina
authors.initials: E
authors.lastname: Kurashita
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Takeda
authors.forename: Osamu
authors.initials: O
authors.lastname: Nomura
authors.forename: Yuka
authors.initials: Y
authors.lastname: Fukuo
authors.forename: Kenshi
authors.initials: K
authors.lastname: Matsumoto
authors.forename: Naoto
authors.initials: N
authors.lastname: Sakamoto
authors.forename: Taro
authors.initials: T
authors.lastname: Osada
authors.forename: Akihito
authors.initials: A
authors.lastname: Nagahara
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Ogihara
authors.forename: Sumio
authors.initials: S
authors.lastname: Watanabe
mesh_terms: D053704:Capsule Endoscopy; D003116:Color; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007410:Intestinal Diseases / Q000175:diagnosis*; D007421:Intestine, Small; D008297:Male