Area riservata
Terapia endoscopica dell'ulcera gastrica sanguinante
Wiki Specialistica gastrologia
| Capsule endoscopy with flexible spectral imagingcolor enhancement reduces the bile pigment effectand improves the detectability of small bowel lesions |
| Scritto da BMC Gastroenterology |
 Background:Capsule endoscopy with flexible spectral imaging color enhancement (CE-FICE) has beenreported to improve the visualization and detection of small-bowel lesions, however, itsclinical usefulness is still not established. Therefore, we conducted a study to evaluatewhether CE-FICE contributes to improve the detectability of small-bowel lesions by CEtrainees.Methods:Four gastroenterology trainees without prior CE experience were asked to read and interpret12 CE videos. Each of the videos was read by conventional visualization method and underthree different FICE settings. To evaluate whether the lesion recognition ability of the CEtrainees could be improved by the FICE technology, the lesion detection rate under each ofthe three FICE settings was compared with that by conventional CE. CE trainees tend to misssmall-bowel lesions in bile-pigment-positive condition, therefore we evaluated whether CEFICEcontributes to reducing the bile-pigment effect. The bile-pigment condition wasdetermined by the color values around the small-bowel lesions according to the results of thereceiver-operating-characteristic analysis. Moreover, we also evaluated whether poor bowelpreparion might affect the accuracy of lesion recognition by CE-FICE.Results:Of a total of 60 angioectasias, CE trainees identified 26 by conventional CE, 40 under FICEsetting 1, 38 under FICE setting 2, and 31 under FICE setting 3. Of a total of 82erosions/ulcerations, CE trainees identified 38 by conventional CE, 62 under FICE setting 1,60 under FICE setting 2, and 20 under FICE setting 3. Compared with conventional CE,FICE settings 1 and 2 significantly improved the detectability of angioectasia (P = 0.0017 andP = 0.014, respectively) and erosions/ulcerations (P = 0.0012 and P = 0.0094, respectively).Although the detectability of small-bowel lesions by conventional CE (P = 0.020) and underFICE setting 2 (P = 0.0023) was reduced by the presence of bile-pigments, that under FICEsetting 1 was not affected (P = 0.59). Our results also revealed that in poor bowel visibilityconditions, CE-FICE yielded a high rate of false-positive findings.Conclusions:CE-FICE may reduce the bile-pigment effect and improve the detectability of small-bowellesions by CE trainees; the reliability of CE-FICE may be improved by good bowelpreparation.Fonte: BMC Gastroenterology |