title: Clinical validity of flexible spectral imaging color enhancement (FICE) in small-bowel capsule endoscopy: a systematic review and meta-analysis.
abstract: Patients and methodsA 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 byI2. Repeated-measures analysis of variance (ANOVA) was used to measure differences in lesion detection between WLE and the three FICE modes.Results13 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 withI2> 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.ConclusionsOverall, 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.
authors.affiliation: Centre for Liver and Digestive Disorders, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom.
authors.forename: Diana E
authors.initials: DE
authors.lastname: Yung
authors.affiliation: Gastroenterology Department, Hospital Senhora da Oliveira, Guimarães, Portugal.
authors.forename: Pedro
authors.initials: P
authors.lastname: Boal Carvalho
authors.affiliation: Faculty of Economics and Management, Open University of Cyprus, Nicosia, Cyprus.
authors.forename: Andry
authors.initials: A
authors.lastname: Giannakou
authors.affiliation: Department of Gastroenterology, Sheba Medical Center, Tel Hashomer, and Sackler School of Medicine, Tel Aviv University, Israel.
authors.forename: Uri
authors.initials: U
authors.lastname: Kopylov
authors.affiliation: Gastroenterology Department, Hospital Senhora da Oliveira, Guimarães, Portugal.
authors.forename: Bruno
authors.initials: B
authors.lastname: Rosa
authors.affiliation: Gastroenterology Unit, Valduce Hospital, Como, Italy.
authors.forename: Emanuele
authors.initials: E
authors.lastname: Rondonotti
authors.affiliation: Department of Gastroenterology, Skåne University Hospital, Lund University, Malmö, Sweden.
authors.forename: Ervin
authors.initials: E
authors.lastname: Toth
authors.affiliation: Centre for Liver and Digestive Disorders, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom.
authors.forename: John N
authors.initials: JN
authors.lastname: Plevris
authors.affiliation: Centre for Liver and Digestive Disorders, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom.
authors.forename: Anastasios
authors.initials: A
authors.lastname: Koulaouzidis
mesh_terms: D053704:Capsule Endoscopy / Q000379:methods*; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007410:Intestinal Diseases / Q000000981:diagnostic imaging*; D007421:Intestine, Small / Q000000981:diagnostic imaging*; D015233:Models, Statistical; D061848:Optical Imaging / Q000379:methods*