Validation of SPICE, a method to differenciate small bowel submucosal lesions from innocent bulges on capsule endoscopy

Revista Espanola de Enfermedades Digestivas

Rolando Pinho¹  Joana Silva¹  Adélia Rodrigues¹  João Carvalho¹  Ana Ponte¹  Jaime P. Rodrigues¹  Mafalda Sousa¹ 

[1] Centro Hospitalar Vila Nova de Gaia/Espinho;

关键词: Capsule endoscopy;    SPICE;    Submucosal lesions;    Intestinal neoplasms;    Innocent bulges;   

DOI  :  10.17235/reed.2017.4629/2016

来源: DOAJ

【 摘 要 】

Background and aims: Small bowel submucosal lesions (SBSL) and innocent bulges may have an identical appearance and be difficult to distinguish on small bowel capsule endoscopy (SBCE). Recently, Girelli et al. proposed a score, smooth, protruding lesion index on capsule endoscopy (SPICE), in order to differentiate between the two. We aimed to evaluate and validate SPICE as a differentiation method between innocent bulges and SBSLs. Methods: We evaluated all SBCEs performed in our department between January 2005 and September 2015, and selected the ones with a smooth, round, protruding lesion in the small bowel. Lesions with suspicious characteristics were excluded. A video clip of the region of interest was created and SPICE was assigned blindly and independently by two endoscopists. We determined the discriminative ability of SPICE using the definitive diagnosis of each patient as the standard criteria. Results: We included 30 SBCEs corresponding to 12 SBSLs (four gastrointestinal stromal tumors, two neuroendocrine tumors, four lipomas and two polypoid lymphangiectasias) and 18 innocent bulges. SPICE scores ranged from 0 to 4, allowing the distinction between SBSLs and innocent bulges (p < 0.001). SPICE > 2 had a 66.7% sensitivity, 100.0% specificity, 100.0% positive predictive value and 78.3% negative predictive value, and the area under the curve was 0.88 (95% CI, 0.73-1.00; p < 0.001) for the diagnosis of SBSL. Conclusions: Our data support SPICE, namely a score > 2, as a predictive method of SBSLs. Taking into account its simplicity, it may be very useful in the distinction between SBSLs and innocent bulges on SBCE.

【 授权许可】

Unknown