Improving Diagnostic Yield of Capsule Endoscopy in Coeliac Disease: Can Flexible Spectral Imaging Colour Enhancement Play a Role?

Abstract

Introduction: Flexible spectral imaging colour enhancement (FICE) is a form of virtual chromoendoscopy that is incorporated in the capsule reading software and that can be used by reviewers to enhance the delineation of lesions in the small bowel. This has been shown to be useful in the detection of pigmented (ulcers, angioectasias) lesions. However, its application to coeliac disease (CD) images from small bowel capsule endoscopies (SBCEs) has rarely been studied. Methods: This was a European, multicentre study that included 5 expert capsule reviewers who were asked to evaluate a number of normal and abnormal de-identified images from SBCEs of patients with CD to determine whether the use of FICE and blue light can improve the detection of CDrelated changes. Results: Sensitivity and specificity of conventional white light in the delineation of CD-related changes were 100%. The next best image modification was FICE 1 with a sensitivity of 80% and a specificity of 100%. There was no difference between conventional white light, FICE and blue light for the identification of CD-related changes. There was a low agreement (Fleiss kappa 0.107; p = 0.147) between expert reviewers in selecting the best image modification that detected CD-related changes. Conclusions: FICE and blue light were not found to be superior to conventional white light in the delineation of macroscopic changes related to CD on SBCEs.

Image-Enhanced Capsule Endoscopy Improves the Identification of Small Intestinal Lesions

“…With FICE 3, improvement of the delineation was achieved for 46.2% of the angioectasias, 24.5% of the ulcers/erosions, and no cases of villous edema/atrophy. Chetcuti Zammit et al [43] reported that FICE was not useful compared with conventional WLI for the delineation of mucosal changes related to celiac disease. In their study, five expert reviewers evaluated several normal and abnormal CE images obtained from the patients with celiac disease to determine whether the use of FICE can improve the detection of celiac disease-related changes.…”

講座

“…からもわかるように，ヒトの視覚は波長700 nm 以 上の光に対する感度が無い．そこで700 nm 上を赤外領域 と呼び，近赤外域(波長700 nm 2.5 mm) ，中赤外域(2.5 mm 10 mm) ，遠赤外域(10 mm 1 mm)に分類する．ただ Tm, Yb から445 nm と810 nm の発光を得，Y 2 O 3 : Er, Yb からは660 nm と 1530 nm の発光を得ると同時に，CL によっても両者から それぞれ445 nm と660 nm の発光を得たことを報告して いる 31) ．また，山中らは1550 nm の励起下で NaYF 4 : Er, Yb から550 nm と660 nm の発光を得ており，2 光子励起 によらずとも，通常の CW レーザーで深部にある組織の 可視化ができると述べている 32) 次除菌を行う．除菌に成功すれば 13 CO 2 が生成さ れないため，呼気中の 13 CO 2 と 12 CO 2 の比は大気と同じ (1 : 100)である．したがって呼気中の 13 CO 2 と 12 CO 2…”