{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T03:23:48Z","timestamp":1778297028665,"version":"3.51.4"},"reference-count":25,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2022,7,28]],"date-time":"2022-07-28T00:00:00Z","timestamp":1658966400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>The usefulness of virtual chromoendoscopy (VC) in capsule endoscopy (CE) isa controversial issue, with conflicting studies regarding its efficacy. FICE and a blue filter were embedded in the PillCamTM software, with the aim to assist readers in identifying the source of obscure gastrointestinal (GI) bleeding (OGIB), coeliac disease mucosal changes and other small and large bowel lesions, including polyps and tumors. This review aims to summarize the existing evidence on the value of VC in the visualization and identification of different types of pathology. Overall, VC in CE with FICE 1 and 2 can be a useful adjunctive tool and may increase the visibility of pigmented lesions, such as angiectasias and ulcers. However, it does not appear to improve the detection of polyps or tumors. On the other hand, the role of FICE 3 and the blue filter appears to be limited. FICE may also be helpful in differentiating hyperplastic and adenomatous colonic polyps during colon capsule endoscopy, although more evidence is needed.<\/jats:p>","DOI":"10.3390\/diagnostics12081818","type":"journal-article","created":{"date-parts":[[2022,7,28]],"date-time":"2022-07-28T20:49:28Z","timestamp":1659041368000},"page":"1818","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Virtual Chromoendoscopy in Capsule Endoscopy: A Narrative Review"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2642-1367","authenticated-orcid":false,"given":"Alexandros","family":"Toskas","sequence":"first","affiliation":[{"name":"Wolfson Unit for Endoscopy, St Mark\u2019s Hospital, Harrow HA1 3UJ, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Faidon-Marios","family":"Laskaratos","sequence":"additional","affiliation":[{"name":"Wolfson Unit for Endoscopy, St Mark\u2019s Hospital, Harrow HA1 3UJ, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3175-5548","authenticated-orcid":false,"given":"Sergio","family":"Coda","sequence":"additional","affiliation":[{"name":"Digestive Diseases Centre, Barking Havering and Redbridge University Hospitals NHS Trust 2, Dagenham RM7 0AG, UK"},{"name":"Photonics Group, Department of Physics, Imperial College London, London SW7 2AZ, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,7,28]]},"reference":[{"key":"ref_1","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":"Yung","year":"2017","journal-title":"Endoscopy"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1159\/000485347","article-title":"Evaluation of the Usefulness of Virtual Chromoendoscopy with Different Color Modes in the MiroCam\u00ae System for Characterization of Small Bowel Lesions","volume":"25","author":"Pinho","year":"2018","journal-title":"GE-Port. J. Gastroenterol."},{"key":"ref_3","first-page":"1474","article-title":"Usefulness of flexible spectral imaging color enhancement (FICE) for the detection of angiodysplasia in the preview of capsule endoscopy","volume":"59","author":"Nakamura","year":"2012","journal-title":"Hepatogastroenterology"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Ogata, N., Ohtsuka, K., Ogawa, M., Maeda, Y., Ishida, F., and Kudo, S.E. (2021). Image-Enhanced Capsule Endoscopy Improves the Identification of Small Intestinal Lesions. Diagnostics, 11.","DOI":"10.3390\/diagnostics11112122"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1016\/j.dld.2015.11.011","article-title":"Virtual chromoendoscopy improves the diagnostic yield of small bowel capsule endoscopy in obscure gastrointestinal bleeding","volume":"48","author":"Carvalho","year":"2016","journal-title":"Dig. Liver Dis."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1016\/j.bpg.2015.06.003","article-title":"Image-enhanced capsule endoscopy for characterization of small bowel lesions","volume":"29","year":"2015","journal-title":"Best Pract. Res. Clin. Gastroenterol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"E315","DOI":"10.1055\/s-0044-102092","article-title":"White light-emitting contrast image capsule endoscopy for visualization of small intestine lesions: A pilot study","volume":"6","author":"Ogata","year":"2018","journal-title":"Endosc. Int. Open"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"E615","DOI":"10.1055\/s-0034-1393063","article-title":"Is virtual chromoendoscopy useful in the evaluation of subtle ulcerative small-bowel lesions detected by video capsule endoscopy?","volume":"3","author":"Negreanu","year":"2015","journal-title":"Endosc. Int. Open"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Sakai, E., Endo, H., Kato, S., Matsuura, T., Tomeno, W., Taniguchi, L., Uchiyama, T., Hata, Y., Yamada, E., and Ohkubo, H. (2012). Capsule endoscopy with flexible spectral imaging color enhancement reduces the bile pigment effect and improves the detectability of small bowel lesions. BMC Gastroenterol., 12.","DOI":"10.1186\/1471-230X-12-83"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"359","DOI":"10.4253\/wjge.v6.i8.359","article-title":"Virtual chromoendoscopy in small bowel capsule endoscopy: New light or a cast of shadow?","volume":"6","author":"Cotter","year":"2014","journal-title":"World J. Gastrointest. Endosc."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"E80","DOI":"10.1055\/s-0034-1365526","article-title":"Clinical utility of capsule endoscopy with flexible spectral imaging color enhancement for diagnosis of small bowel lesions","volume":"2","author":"Sato","year":"2014","journal-title":"Endosc. Int. Open"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"735","DOI":"10.1097\/MEG.0000000000000358","article-title":"Improving diagnostic yield in obscure gastrointestinal bleeding\u2014How virtual chromoendoscopy may be the answer","volume":"27","author":"Rosa","year":"2015","journal-title":"Eur. J. Gastroenterol. Hepatol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1133","DOI":"10.3109\/00365521.2011.584899","article-title":"Improved detectability of small-bowel lesions via capsule endoscopy with computed virtual chromoendoscopy: A pilot study","volume":"46","author":"Imagawa","year":"2011","journal-title":"Scand. J. Gastroenterol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1016\/j.gastrohep.2012.08.004","article-title":"Utility of capsule endoscopy with flexible spectral imaging color enhancement in the diagnosis of small bowel lesions","volume":"36","author":"Asanza","year":"2013","journal-title":"Gastroenterol. Hepatol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1055\/s-0029-1243994","article-title":"Computed image modification for enhancement of small-bowel surface structures at video capsule endoscopy","volume":"42","author":"Pohl","year":"2010","journal-title":"Endoscopy"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"501","DOI":"10.3109\/00365521.2013.873480","article-title":"Usefulness of flexible spectral imaging color enhancement for the detection and diagnosis of small intestinal lesions found by capsule endoscopy","volume":"49","author":"Konishi","year":"2014","journal-title":"Scand. J. Gastroenterol."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Aoyama, T., Fukumoto, A., Shigita, K., Asayama, N., Mukai, S., and Nagata, S. (2020). Bile pigment in small-bowel water content may reflect bowel habits: A retrospective analysis of a capsule endoscopy imaging series. BMC Gastroenterol., 20.","DOI":"10.1186\/s12876-020-01382-0"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"614","DOI":"10.1111\/j.1751-2980.2012.00641.x","article-title":"Efficacy of flexible spectral imaging color enhancement on the detection of small intestinal diseases by capsule endoscopy","volume":"13","author":"Kobayashi","year":"2012","journal-title":"J. Dig. Dis."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"231","DOI":"10.4321\/S1130-01082012000500002","article-title":"Virtual chromoendoscopy can be a useful software tool in capsule endoscopy","volume":"104","author":"Duque","year":"2012","journal-title":"Rev. Esp. Enferm. Dig."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"953","DOI":"10.1016\/j.dld.2011.07.018","article-title":"Chromoendoscopy in small bowel capsule endoscopy: Blue mode or Fuji Intelligent Colour Enhancement?","volume":"43","author":"Krystallis","year":"2011","journal-title":"Dig. Liver Dis."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"33","DOI":"10.4253\/wjge.v4.i2.33","article-title":"Blue mode does not offer any benefit over white light when calculating Lewis score in small-bowel capsule endoscopy","volume":"4","author":"Koulaouzidis","year":"2012","journal-title":"World J. Gastrointest. Endosc."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"4590","DOI":"10.3748\/wjg.v17.i41.4590","article-title":"Evaluation of Fujinon intelligent chromo endoscopy-assisted capsule endoscopy in patients with obscure gastroenterology bleeding","volume":"17","author":"Gupta","year":"2011","journal-title":"World J. Gastroenterol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"421","DOI":"10.4253\/wjge.v4.i9.421","article-title":"Efficacy of computed image modification of capsule endoscopy in patients with obscure gastrointestinal bleeding","volume":"4","author":"Matsumura","year":"2012","journal-title":"World J. Gastrointest. Endosc."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1159\/000500906","article-title":"Improving Diagnostic Yield of Capsule Endoscopy in Coeliac Disease: Can Flexible Spectral Imaging Colour Enhancement Play a Role?","volume":"101","author":"Zammit","year":"2020","journal-title":"Digestion"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1805","DOI":"10.2169\/internalmedicine.6446-20","article-title":"The differential diagnosis of colorectal polyps using colon capsule endoscopy","volume":"60","author":"Nakazawa","year":"2021","journal-title":"Intern. Med."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/12\/8\/1818\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T23:58:18Z","timestamp":1760140698000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/12\/8\/1818"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7,28]]},"references-count":25,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2022,8]]}},"alternative-id":["diagnostics12081818"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics12081818","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,7,28]]}}}