Blue mode does not offer any benefit over white light when calculating Lewis score in small-bowel capsule endoscopy

To check the usefulness of blue mode (BM) review in lewis score (LS) calculation, by comparing it with respective LS results obtained by white light (WL) small-bowel capsule endoscopy (SBCE) review and mucosal inflammation as reflected by faecal calprotectin (FC) levels, considered as 'gold standard' for this study.

Computational analysis of our SBCE database to identify patients who underwent SBCE with PillCam(®) and had FC measured within a 30-day period from their test. Only patients with prior colonoscopy were included, to exclude any colon pathology-associated FC rise. Each small bowel tertile was reviewed (viewing speed 8 fps) with WL and BM, in a back-to-back mode, by a single experienced reviewer. LS were calculated after each WL and BM reviews. Pearson rank correlation (rho, r) statistic was applied.

Twenty-seven (n = 27, 20F/7M) patients were included. Thirteen (n = 13) had SBCE with PillCam(®)SB1, and the remainder (n = 14) with PillCam(®)SB2. The median level of FC in this cohort was 125 μg/g. LS (calculated in WL SBCE review) correlation with FC levels was r = 0.490 (P = 0.01), while for BM review and LS correlation with FC was r = 0.472 (P = 0.013).

Although BM is believed to enhance mucosal details i.e., small mucosal breaks, it did not perform better than WL in the calculation of LS in our cohort.