{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T08:10:29Z","timestamp":1778227829781,"version":"3.51.4"},"reference-count":13,"publisher":"Georg Thieme Verlag KG","issue":"CP","license":[{"start":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T00:00:00Z","timestamp":1773619200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endosc Int Open"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Second-generation colon capsule endoscopy (CCE) has achieved high diagnostic accuracy\n        for polyp detection. However, its widespread adoption as a filter test is hampered by major\n        cost-effectiveness concerns, due to significant follow-up endoscopy rates (FER), quantified\n        as high as 42%, thus revealing a potential paradox: CCE superior detection of\n        un-characterized lesions may worsen the economic problem. Flexible spectral imaging color\n        enhancement (FICE) is a standard virtual chromoendoscopy tool, but its role in CCE has been\n        considered uncertain. This scoping review aimed to evaluate available evidence on FICE in\n        addressing CCE limitations in lesion detection and characterization.<\/jats:p>\n                  <jats:p>A systematic literature search identified studies investigating use of FICE in CCE, focusing on studies analyzing FICE performance in improving detection rates and differentiating polyp histology.<\/jats:p>\n                  <jats:p>Two key studies representing complementary evidence were analyzed. Regarding detection,\n        a prospective trial demonstrated that FICE significantly improved overall per-lesion\n        sensitivity compared with white light (WL) (79% vs. 61%). Specifically, FICE outperformed WL\n        for 6-9-mm polyps (93% vs. 65%), flat\/non-protruding lesions (75% vs. 53%), and serrated\n        polyps (74% vs. 57%). Regarding characterization, a quantitative colorimetric analysis\n        identified that the color difference between polyps and mucosa in FICE reliably\n        discriminates histology, yielding a 0.928 area-under-the-curve (AUC), with 91.2% sensitivity\n        and 88.2% specificity.<\/jats:p>\n                  <jats:p>FICE may play a complementary role in CCE, significantly improving detection of high-risk flat\/serrated lesions and providing objective data for differentiating adenomas from hyperplastic polyps. Integrating FICE into diagnostic workflows could provide a smart solution to address CCE high FER and cost-effectiveness barriers.<\/jats:p>","DOI":"10.1055\/a-2821-8380","type":"journal-article","created":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T00:30:37Z","timestamp":1773707437000},"source":"Crossref","is-referenced-by-count":0,"special_numbering":"S","title":["Flexible spectral imaging color enhancement in colon capsule endoscopy: Scoping review of evidence for lesion detection and characterization"],"prefix":"10.1055","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8793-5890","authenticated-orcid":false,"given":"Pablo","family":"Cortegoso Valdivia","sequence":"additional","affiliation":[{"name":"Gastroenterology and Endoscopy Unit, University Hospital of Parma, Parma, Italy"},{"name":"Surgical Research Unit, Odense University Hospital, Svendborg, Denmark"},{"name":"Department of Clinical Research, University of Southern Denmark, Odense, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9314-9239","authenticated-orcid":false,"given":"Ervin","family":"Toth","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Sk\u00e5ne University Hospital, Lund University, Malm\u00f6, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anastasios","family":"Koulaouzidis","sequence":"additional","affiliation":[{"name":"Surgical Research Unit, Odense University Hospital, Svendborg, Denmark"},{"name":"Department of Clinical Research, University of Southern Denmark, Odense, Denmark"},{"name":"Department of Medicine, Odense University Hospital, Svendborg, Denmark"},{"name":"Department of Social Medicine & Public Health, Pomeranian Medical University in Szczecin, Szczecin, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2026,3,16]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1055\/a-1249-3938","article-title":"Diagnostic accuracy of capsule endoscopy compared with colonoscopy for polyp detection: Systematic review and meta-analyses","volume":"53","author":"T Kj\u00f8lhede","year":"2021","journal-title":"Endoscopy"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"3367","DOI":"10.3390\/cancers12113367","article-title":"Colon capsule endoscopy vs. CT colonography following incomplete colonoscopy: A systematic review with meta-analysis","volume":"12","author":"U Deding","year":"2020","journal-title":"Cancers (Basel)"},{"key":"ref3","first-page":"1","article-title":"Systematic meta-review: diagnostic accuracy of colon capsule endoscopy for colonic neoplasia with umbrella meta-analysis","volume":"18","author":"II Lei","year":"2025","journal-title":"Ther Adv Gastrointest Endosc"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"2121","DOI":"10.1111\/codi.17208","article-title":"Colon capsule endoscopy: A bitter pill?","volume":"26","author":"R Jardine","year":"2024","journal-title":"Colorectal Dis"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1055\/a-2641-5952","article-title":"Colon capsule endoscopy today: Brief overview of leading UK and Danish initiatives","volume":"13","author":"JF Justsen","year":"2025","journal-title":"Endosc Int Open"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgast-2025-001800","article-title":"Follow-up endoscopy rates as an indicator of effectiveness in colon capsule endoscopy: a systematic review and meta-analysis","volume":"12","author":"II Lei","year":"2025","journal-title":"BMJ Open Gastroenterol"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1055\/a-2495-5427","article-title":"Unifying terminology, reporting, and bowel preparation standards in colon capsule endoscopy: Nyborg Consensus","volume":"13","author":"II Lei","year":"2025","journal-title":"Endosc Int Open"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"7034","DOI":"10.3390\/jcm13237034","article-title":"Polyp matching in colon capsule endoscopy: Pioneering CCE-colonoscopy integration towards an AI-driven future","volume":"13","author":"II Lei","year":"2024","journal-title":"J Clin Med"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1055\/s-0042-122015","article-title":"Clinical validity of flexible spectral imaging color enhancement (FICE) in small-bowel capsule endoscopy: a systematic review and meta-analysis","volume":"49","author":"DE Yung","year":"2017","journal-title":"Endoscopy"},{"key":"ref10","doi-asserted-by":"crossref","DOI":"10.1177\/17562848241242681","article-title":"Rationalizing polyp matching criteria in colon capsule endoscopy: an international expert consensus through RAND (modified DELPHI) process","volume":"17","author":"II Lei","year":"2024","journal-title":"Ther Adv Gastroenterol"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"467","DOI":"10.7326\/M18-0850","article-title":"PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and explanation","volume":"169","author":"AC Tricco","year":"2018","journal-title":"Ann Intern Med"},{"key":"ref12","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1016\/j.gie.2023.09.002","article-title":"Prospective study of diagnostic yields of flexible spectral imaging color enhancement installed in colon capsule endoscopy for colorectal polyps and tumors","volume":"99","author":"T Omori","year":"2024","journal-title":"Gastrointest Endosc"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"1805","DOI":"10.2169\/internalmedicine.6446-20","article-title":"The differential diagnosis of colorectal polyps using colon capsule endoscopy","volume":"60","author":"K Nakazawa","year":"2021","journal-title":"Intern Med"}],"container-title":["Endoscopy International 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