Usefulness of flexible spectral imaging color enhancement (FICE) for the detection of angiodysplasia in the preview of capsule endoscopy

Backgrounds/Aims: Flexible spectral imaging color enhancement (FICE) is an image enhancement system that can obtain bright and high-contrast images. FICE for capsule endoscopy (CE) is available during interpretation of Given Imaging, but its usefulness is rarely reported. The aim of this study is to evaluate the preview of angiodysplasia by FICE in comparison with the conventional preview. Methodology: The accumulated CE data of 50 patients with angiodysplasia were randomly assigned to 2 equally sized groups of conventional reading and FICE reading. One experienced doctor analyzed them for the first time in a quick-view mode and the mean reading time, sensitivity and specificity for detecting angiodysplasia by each method were evaluated for comparisons including suspected blood indicator. Results: The mean reading time was 14min for both conventional reading and FICE reading. The two previews of angiodysplasia were significantly superior to the function of suspected blood indicator (p<0.01). The sensitivity and specificity of conventional reading for detecting angiodysplasia were 80% and 100%, respectively. Those of FICE reading were 91% and 86%, respectively. FICE reading was superior in term of sensitivity, while it resulted in more false-positive lesion findings and lower specificity. However, such false-positive findings by FICE reading can be correctly identified at a glance by converting the image to conventional mode. Conclusions: This study demonstrates that FICE enables accurate detection of angiodysplasia in the preview of CE.