Brief Article
Copyright ©2011 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Nov 7, 2011; 17(41): 4590-4595
Published online Nov 7, 2011. doi: 10.3748/wjg.v17.i41.4590
Evaluation of Fujinon intelligent chromo endoscopy-assisted capsule endoscopy in patients with obscure gastroenterology bleeding
Tarun Gupta, Mostafa Ibrahim, Jacques Deviere, André Van Gossum
Tarun Gupta, Mostafa Ibrahim, Jacques Deviere, André Van Gossum, Department of Hepato-Gastroenterology, Erasme Hospital-Free University of Brussels, Route de Lennik, 808, 1070 Brussels, Belgium
Author contributions: Gupta T and Ibrahim M contributed equally to the work; Gupta T, Ibrahim M, Deviere J and Van Gossum A designed the research; Gupta T, Ibrahim M and Van Gossum A performed the research; Gupta T and Ibrahim M performed the statistical analysis; and Gupta T and Van Gossum A wrote the paper.
Correspondence to: André Van Gossum, MD, PhD, Department of Hepato-Gastroenterology, Erasme Hospital-Free University of Brussels, Route de Lennik, 808, 1070 Brussels, Belgium. andre.vangossum@erasme.ulb.ac.be
Telephone: +32-25-553712 Fax: +32-25-554697
Received: March 4, 2011
Revised: April 23, 2011
Accepted: April 30, 2011
Published online: November 7, 2011
Abstract

AIM: To investigate the potential benefit of Fujinon intelligent chromo endoscopy (FICE)-assisted small bowel capsule endoscopy (SBCE) for detection and characterization of small bowel lesions in patients with obscure gastroenterology bleeding (OGIB).

METHODS: The SBCE examinations (Pillcam SB2, Given Imaging Ltd) were retrospectively analyzed by two GI fellows (observers) with and without FICE enhancement. Randomization was such that a fellow did not assess the same examination with and without FICE enhancement. The senior consultant described findings as P0, P1 and P2 lesions (non-pathological, intermediate bleed potential, high bleed potential), which were considered as reference findings. Main outcome measurements: Inter-observer correlation was calculated using kappa statistics. Sensitivity and specificity for P2 lesions was calculated for FICE and white light SBCE.

RESULTS: In 60 patients, the intra-class kappa correlations between the observers and reference findings were 0.88 and 0.92 (P2), 0.61 and 0.79 (P1), for SBCE using FICE and white light, respectively. Overall 157 lesions were diagnosed using FICE as compared to 114 with white light SBCE (P = 0.15). For P2 lesions, the sensitivity was 94% vs 97% and specificity was 95% vs 96% for FICE and white light, respectively. Five (P2 lesions) out of 55 arterio-venous malformations could be better characterized by FICE as compared to white light SBCE. Significantly more P0 lesions were diagnosed when FICE was used as compared to white light (39 vs 8, P < 0.001).

CONCLUSION: FICE was not better than white light for diagnosing and characterizing significant lesions on SBCE for OGIB. FICE detected significantly more non-pathological lesions. Nevertheless, some vascular lesions could be more accurately characterized with FICE as compared to white light SBCE.

Keywords: Endoscopy; Video-capsule; Small bowel; Obscure gastrointestinal bleeding; Arterio-venous malformation; Fujinon intelligent chromo endoscopy