Progress in digestive endoscopy: Flexible Spectral Imaging Colour Enhancement (FICE)-technical review

Area of Science:

• Gastroenterology and Endoscopy
• Medical Imaging Technology

Background:

• Digital chromoendoscopy, including Flexible spectral Imaging Color Enhancement (FICE), has emerged as a significant advancement in digestive endoscopy.
• FICE offers a virtual coloration technique as a potentially quicker and more effective alternative to traditional dye spraying methods.

Purpose of the Study:

• To evaluate the diagnostic utility and applications of Flexible spectral Imaging Color Enhancement (FICE) in various gastrointestinal conditions.
• To assess FICE's effectiveness in detecting and characterizing lesions compared to conventional endoscopic techniques.

Main Methods:

• Review of current evidence on the application of FICE in esophagitis, Barrett's esophagus, esophageal cancer, gastric cancer, colon cancer, inflammatory bowel disease, and video capsule endoscopy.
• Comparative analysis of FICE's performance against dye-based chromoendoscopy and standard white-light endoscopy.

Main Results:

• FICE enhances the detection of minimal esophagitis, dysplasia in Barrett's esophagus, and squamous cell esophageal cancer.
• It improves visualization of early gastric cancer, being less invasive and time-consuming than dye methods.
• While not recommended for colon cancer screening, FICE aids in colonic lesion characterization and is considered progress in video capsule endoscopy, though its role in IBD remains debated.

Conclusions:

• Routine use of FICE endoscopy can potentially increase diagnostic yield and improve lesion characterization.
• Further studies are required to validate FICE's optimal channel selection, define precise indications, and establish standardized classifications.