Abstract
Background and AimsWe prospectively aimed to determine the efficacy of flexible spectral imaging color enhancement (FICE) at second-generation colon capsule endoscopy (CCE) for colorectal polyps and tumors (CRTs). MethodsThis study included optical colonoscopy within four months after CCE. Two colonoscopists independently reviewed white light images (CCE-WL) and FICE images (CCE-FICE), respectively. Based on colonoscopic findings as the gold standard, the diagnostic accuracy for CRTs was compared between CCE-WL and CCE-FICE. ResultsOf 89 enrolled patients (65 men and 24 women; 75 with CRTs including 36 with serrated lesions, 63 with adenomas, and 9 with adenocarcinomas), the per-patient detectability of CCE-FICE for the representative CRT was significantly higher than that of CCE-WL: overall CRTs (CCE-WL,79%; CCE-FICE,88%, P=0.0001), 6-9 mm CRTs (63%; 94%, P=0.0055), ≥6mm CRTs (78%; 93%, P=0.0159), respectively. The per-lesion sensitivity of CCE-FICE was significantly higher than that of CCE-WL for CRTs: overall (61%; 79%, P<0.0001), <6 mm (53%; 69%, P<0.0001) and 6-9 mm CRTs (65%; 93%, P=0.0007), slightly elevated CRTs (53%; 75 %, P<0.0001), tubular adenomas (61%; 79%, P<0.0001), and serrated polyps (57%; 74%, P=0.0022), respectively. Both modes detected all adenocarcinomas. There were no significant differences of the per-lesion sensitivity for ≥10 mm or protruding CRTs between CCE-WL and CCE-FICE (81%; 94%, P=0.1138, 77%; 86%, P=0.0614, respectively). Kappa coefficients for overall CRTs at CCE-WL and CCE-FICE were 0.66 and 0.64, respectively, which indicated substantial agreement. ConclusionsCCE-FICE improved the detection rates for all CRTs except adenocarcinomas, ≥10 mm and protruding polyps, when compared to CCE-WL (UMIN 000021125).
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