title: Virtual chromoendoscopy improves the diagnostic yield of small bowel capsule endoscopy in obscure gastrointestinal bleeding.
abstract: BACKGROUND
  Small bowel capsule endoscopy represents the initial investigation for obscure gastrointestinal bleeding. Flexible spectral imaging colour enhancement (FICE) is a virtual chromoendoscopy technique designed to enhance mucosal lesions, available in different settings according to light wavelength-- FICE1, 2 and 3.
  
  
  OBJECTIVE
  To compare the diagnostic yield of FICE1 and white light during capsule endoscopy in patients with obscure gastrointestinal bleeding.
  
  
  METHODS
  Retrospective single-centre study including 60 consecutive patients referred for small bowel capsule endoscopy for obscure gastrointestinal bleeding. Endoscopies were independently reviewed in FICE1 and white light; findings were then reviewed by another researcher, establishing a gold standard. Diagnostic yield was defined as the presence of lesions with high bleeding potential (P2) angioectasias, ulcers or tumours.
  
  
  RESULTS
  Diagnostic yield using FICE1 was significantly higher than white light (55% vs. 42%, p=0.021). A superior number of P2 lesions was detected with FICE1 (74 vs. 44, p=0.003), particularly angioectasias (54 vs. 26, p=0.002), but not ulcers or tumours.
  
  
  CONCLUSIONS
  FICE1 was significantly superior to white light, resulting in a 13% improvement in diagnostic yield, and potentially bleeding lesions particularly angioectasias were more often observed. Our results support the use of FICE1 while reviewing small bowel capsule endoscopy for obscure gastrointestinal bleeding.
authors.affiliation: Alto Ave Hospital, Guimarães, Portugal. Electronic address: Pedroboalcarvalho@chaa.min-saude.pt.
authors.forename: Pedro
authors.initials: P
authors.lastname: Boal Carvalho
authors.affiliation: Alto Ave Hospital, Guimarães, Portugal.
authors.forename: Joana
authors.initials: J
authors.lastname: Magalhães
authors.affiliation: Alto Ave Hospital, Guimarães, Portugal.
authors.forename: Francisca
authors.initials: F
authors.lastname: Dias de Castro
authors.affiliation: Alto Ave Hospital, Guimarães, Portugal.
authors.forename: Tiago Cúrdia
authors.initials: TC
authors.lastname: Gonçalves
authors.affiliation: Alto Ave Hospital, Guimarães, Portugal.
authors.forename: Bruno
authors.initials: B
authors.lastname: Rosa
authors.affiliation: Alto Ave Hospital, Guimarães, Portugal.
authors.forename: Maria João
authors.initials: MJ
authors.lastname: Moreira
authors.affiliation: Alto Ave Hospital, Guimarães, Portugal; Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal; ICVS/3B's, PT Government Associate Laboratory, Guimarães/Braga, Portugal.
authors.forename: José
authors.initials: J
authors.lastname: Cotter
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D053704:Capsule Endoscopy / Q000379:methods*; D003116:Color; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007414:Intestinal Neoplasms / Q000150:complications / Q000175:diagnosis*; D007421:Intestine, Small; D008297:Male; D008875:Middle Aged; D010437:Peptic Ulcer / Q000150:complications / Q000175:diagnosis*; D010438:Peptic Ulcer Hemorrhage / Q000175:diagnosis; D012189:Retrospective Studies; D013684:Telangiectasis / Q000150:complications / Q000175:diagnosis*; D055815:Young Adult
keywords: Capsule endoscopy; Obscure gastrointestinal bleeding; Small bowel diseases; Virtual chromoendoscopy