Clinical utility of capsule endoscopy with flexible spectral imaging color enhancement for diagnosis of small bowel lesions
Clinical utility of capsule endoscopy with flexible spectral imaging color enhancement for diagnosis of small bowel lesions
复制标题
DOI：
10.1055/s-0034-1365526
复制
发表时间：
2014-06-01
影响因子：
2.6
通讯作者：
Kato, Junji
中科院分区：
文献类型：
--
作者：
Sato, Yasushi;Sagawa, Tamotsu;Kato, Junji
背景和研究目的：具有灵活光谱成像色彩增强（FICE）的计算机虚拟色素内窥镜在胶囊内窥镜（CE）中的临床效用仍然存在争议。为了阐明 FICE 增强 CE 在评估小肠病变方面的临床效用，我们定量评估了白光 (WL)、FICE 和蓝色模式 (BM) 图像，并检查了接受 CE 的患者的小肠病变这 3 种成像模式的敏感性。方法：使用 WL 和 FICE 设置 1、2 和 2，测量 261 个 CE 图像（3 个不同病变类别）的 CIELAB 色差 (Delta E) 和视觉模拟量表 (VAS)。分别为图3和BM图像。三位内镜医师使用 WL、3 个 FICE 模式设置和 BM 审查 CE 视频，并比较了 50 例接受 CE 的患者对小肠疾病的敏感性和可检测性。结果：在 152 个血管病变图像的可见度评估中，FICE 设置 1、2 和 BM 图像的 Delta E 和 VAS 显着高于 WL 图像。在88张糜烂/溃疡图像中，FICE组1和组2图像的Delta E和VAS显着高于WL图像。在 21 张肿瘤图像中，这些方式的 Delta E 没有显着差异。对每位患者进行分析时，FICE 设置 1 和 2 对血管病变具有最高的敏感性 (100%) 和特异性 (97.3-100%)。对于糜烂/溃疡性病变，FICE 设置 2 具有最高的敏感性 (100%) 和特异性 (97.2%)。对于肿瘤或息肉，WL 具有最高的敏感性 (90.9%) 和特异性 (87.1%)。在每个病变分析中，对于血管病变，FICE 设置 1 和 2 显示出明显优于 WL 的检测能力。在糜烂/溃疡性病变的检测中，FICE设置2明显优于WL。在肿瘤图像中，相对于 WL 图像，任何设置都没有显着改善。结论：FICE 对于改善 CE 图像质量以及小肠血管扩张和糜烂/溃疡病例的检测最有用。
Background and study aims: The clinical utility of computed virtual chromoendoscopy with flexible spectral imaging color enhancement (FICE) in capsule endoscopy (CE) remains controversial. To clarify the clinical utility of FICE-enhanced CE in evaluating small bowel lesions, we quantitatively assessed white light (WL), FICE, and blue mode (BM) images and examined the sensitivity of these 3 imaging modes of small-bowel lesions from patients who underwent CE.Methods: The CIELAB color difference (Delta E) and visual analogue scales (VAS) were measured in 261CE images (3 different lesion categories) using WL and FICE set 1, 2, and 3, and BM images, respectively. Three endoscopists reviewed CE videos with WL, 3 FICE mode settings, and BM, and compared the sensitivity and detectability for small intestinal diseases from 50 patients who underwent CE.Results: In the assessment of visibility in the 152 vascular lesion images, the Delta E and VAS of FICE set 1, 2, and BM images were significantly higher than that of WL images. In 88 erosion/ulceration images, the Delta E and VAS of FICE set 1 and 2 images were significantly higher than that of WL images. In 21 tumor images, there were no significant differences in Delta E among these modalities. When analyzed on a per-patient basis, FICE settings 1 and 2 had the highest sensitivity (100%) and specificity (97.3-100%) for vascular lesions. As for erosive/ulcerative lesions, FICE setting 2 had the highest sensitivity (100%) and specificity (97.2 %). For tumors or polyps, WL had the highest sensitivity (90.9 %) and specificity (87.1 %). In per-lesion analysis, FICE settings 1 and 2 showed significantly superior detection ability over WL for vascular lesions. In the detection of erosive/ulcerative lesions, FICE setting 2 was significantly superior to WL. In tumor images, there was no significant improvement with any of the settings relative to WL images.Conclusions: FICE is most useful for improving CE image quality and detection in cases of angioectasia and erosion/ulceration of the small intestine.