A review of image-enhanced endoscopy in the evaluation of colonic polyps

Abstract

The practice of colonoscopy has changed considerably over the last decade. The growth of image-enhanced endoscopy have altered our concepts of how we perform colonoscopy. This article examines the evidence base behind these techniques and looks at where future research needs to be directed.

Advances in the endoscopic diagnosis and treatment of Barrett’s neoplasia

“…NBI is the most studied optical imaging technology thus far and has a sensitivity and specificity of 47%–100% and 72%–100%, respectively, for detecting Barrett’s neoplasia 27 , 31 – 34 . NBI selectively enhances mucosal vascular patterns by narrowing the spectrum of light, reducing the amount of red light in the displayed image whilst narrowing the spectrum of blue and green, making blood vessels appear dark against the background mucosa 35 .…”

“…i-Scan. i-Scan uses post-processor technology that reconstructs the image transmitted from the endoscope by using a computer-based algorithm which is able to accentuate both surface patterns and vasculature 35 . A randomised control trial found that the yields of acetic acid-guided versus i-Scan-guided biopsies in detecting specialised columnar epithelium were comparable 36 .…”

“…Three such single-wavelength images can be selected and assigned to the red, green and blue monitor inputs to display a composite colour-enhanced multiband image in real time. This can be used like NBI to remove data from the red part of the waveband and narrow the green and blue spectra 35 .…”

Introductory Chapter: Endoscopy-Novel Techniques and Recent Advancements

“…The fact that some organs could have only been accessed by surgical procedures has promoted endoscopy to a level worthy of further appraisal. Among the different steps in endoscopy, the ones that surely changed the way we tend to diagnose or treat patients in daily practice are endoscopic retrograde cholangiopancreatography [6], capsule endoscopy [7], and endoscopic ultrasound [8,9]. Thus, a new window was opened for both patients and physicians, and allowed the concept of evidencebased medicine to be used in daily practice.…”