A spectral imaging apparatus includes an image sensor positioned to capture images of a target, a rotating color wheel aligned with the image sensor, and a projector positioned to project overlay images onto the target. The color wheel can include one or more filter segments, each allowing light of a different range of wavelengths to pass. The color wheel can further include a blocking or opaque segment. A set of captured images of the different wavelengths can be processed to generate a false-color overlay image for projection onto the target. Processing of overlay images can be performed when the blocking or opaque segment is in front of the image sensor. The spectral imaging apparatus may be a multi-spectral imaging apparatus and made be used in the medical fields, such as for determining and indicating tissue oxygenation. Video rates can be achieved.