Digital illustration showing the transition from traditional colonoscopy to virtual chromoendoscopy.

Virtual Chromoendoscopy: Is This the Future of Colitis Surveillance?

Beau Callahan in Health & Wellness December 2025 • 4 min read.

"A randomized trial reveals virtual chromoendoscopy as a quicker, more comfortable alternative for detecting dysplasia in colitis patients, potentially improving adherence to crucial surveillance programs."

For individuals with ulcerative colitis (UC) or colonic Crohn's disease (CD), the risk of colorectal cancer (CRC) is a significant concern, making regular surveillance colonoscopies a critical part of their healthcare. Traditional chromoendoscopy (CE) is a recommended surveillance method, but its widespread adoption has been limited.

Virtual chromoendoscopy (VCE) offers a promising alternative. By digitally enhancing mucosal images in real-time, VCE eliminates the technical challenges associated with traditional CE. Fujinon Intelligent Colour Enhancement (FICE), a specific VCE technology, has shown promise in detecting adenomas in non-colitis studies.

A recent study, the 'CONVINCE' trial, directly compared VCE to conventional CE, focusing on dysplasia detection, feasibility, and, importantly, patient experience. This research provides crucial insights into whether VCE could overcome the barriers to colitis surveillance and improve patient outcomes.

CONVINCE Trial: VCE vs. Conventional Chromoendoscopy

Digital illustration showing the transition from traditional colonoscopy to virtual chromoendoscopy.

The CONVINCE trial was designed as a randomized crossover study. This means participants underwent both VCE and conventional CE, allowing for a direct comparison of the two techniques within the same individuals. Researchers evaluated several factors, including the ability to detect dysplasia (precancerous changes), the time taken for each procedure, patient-reported pain levels, and overall patient preference.

The study involved 60 patients, with 48 completing both procedures. Key findings from the trial:

Dysplasia Detection: VCE's dysplasia diagnostic accuracy was 93.94%, compared to 76.9% for conventional CE. VCE didn't miss more dysplasia.
Examination Time: VCE was significantly faster, averaging 14 minutes compared to 20 minutes for CE (p < 0.001).
Pain Levels: Patients reported lower pain scores with VCE (27.4 mm on a visual analog scale) compared to CE (34.7 mm).
Patient Preference: A clear majority (67%) of patients preferred VCE, while only 33% preferred conventional CE (p < 0.001).

These results suggest that VCE is not only as good as conventional CE in detecting dysplasia but also offers significant advantages in terms of speed, patient comfort, and overall preference. All which have huge implications for the public considering long term prognosis.

The Future of Colitis Surveillance: VCE's Potential

The CONVINCE trial offers compelling evidence that virtual chromoendoscopy could be a valuable tool in colitis surveillance. Its ease of use, speed, and improved patient experience could lead to greater adherence to surveillance programs, ultimately improving outcomes for individuals at risk of colorectal cancer.

While these results are promising, the researchers emphasize that this was a feasibility trial. A larger, multicenter trial is needed to confirm these findings and further establish the value of VCE in clinical practice. This future research will provide more definitive evidence to guide clinical recommendations.

In the meantime, patients with colitis should discuss the available surveillance options with their gastroenterologist. VCE represents a step forward in making this critical aspect of healthcare more accessible and patient-centered.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1093/ibd/izy360, Alternate LINK

Title: A Randomized Crossover Trial Of Conventional Vs Virtual Chromoendoscopy For Colitis Surveillance: Dysplasia Detection, Feasibility, And Patient Acceptability (Convince)

Subject: Gastroenterology

Journal: Inflammatory Bowel Diseases

Publisher: Oxford University Press (OUP)

Authors: Shraddha Gulati, Patrick Dubois, Ben Carter, Victoria Cornelius, Meredith Martyn, Andrew Emmanuel, Amyn Haji, Bu’Hussain Hayee

Published: 2018-12-20

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Everything You Need To Know

1

What is virtual chromoendoscopy?

Virtual chromoendoscopy (VCE) is a medical imaging technique that digitally enhances images of the colon's lining in real-time. This allows doctors to examine the tissue for signs of dysplasia, which are precancerous changes. Unlike traditional chromoendoscopy (CE), VCE uses software to enhance the images, eliminating the need for dyes. This method provides a detailed view of the colon, aiding in the early detection of potential problems. In the CONVINCE trial, VCE was compared to CE to assess its effectiveness and patient experience.

2

What were the key findings of the CONVINCE trial regarding VCE?

The CONVINCE trial found that VCE offers several advantages over conventional CE. Firstly, VCE was shown to be significantly faster, with an average examination time of 14 minutes compared to CE's 20 minutes. Secondly, patients reported lower pain scores with VCE. Lastly, a clear majority of patients preferred VCE over CE. These factors suggest that VCE can improve the efficiency of colonoscopies, increase patient comfort, and potentially encourage greater adherence to surveillance programs. The enhanced speed and comfort may translate to more patients completing their necessary screenings.

3

Why is detecting dysplasia important for patients with colitis?

Dysplasia is the presence of abnormal cells in the lining of the colon, which can be a precursor to colorectal cancer (CRC). Detecting dysplasia early is crucial for individuals with ulcerative colitis (UC) or colonic Crohn's disease (CD) as they are at higher risk of developing CRC. In the CONVINCE trial, VCE's dysplasia diagnostic accuracy was 93.94%, compared to 76.9% for conventional CE. This indicates VCE is effective and possibly more sensitive at detecting these critical changes in the colon.

4

How does virtual chromoendoscopy (VCE) differ from traditional chromoendoscopy (CE)?

The main difference lies in the method of visualizing the colon lining. Traditional chromoendoscopy (CE) involves applying dyes to the colon to highlight abnormalities. This process can be time-consuming and may cause some discomfort. Virtual chromoendoscopy (VCE), on the other hand, uses digital enhancement technology, such as Fujinon Intelligent Colour Enhancement (FICE), to achieve the same goal without the need for dyes. The CONVINCE trial demonstrated that VCE offers a quicker, more comfortable experience while maintaining or improving diagnostic accuracy compared to CE.

5

What is the significance of the results from the CONVINCE trial?

The implications of the CONVINCE trial's findings are substantial for several reasons. Firstly, VCE's improved patient experience could lead to better compliance with recommended surveillance programs. Secondly, VCE's faster examination time can improve efficiency and make more colonoscopies possible. By potentially detecting dysplasia earlier and improving patient comfort, VCE could improve the overall outcomes of patients, specifically those with UC or CD who are at a higher risk for CRC. The future of colitis surveillance may very well be using VCE, due to the advantages over conventional CE.