Detecting colorectal lesions with image-enhanced endoscopy: an updated review from clinical trials

Abstract

Colonoscopy plays an important role in reducing the incidence and mortality of colorectal cancer by detecting adenomas and other precancerous lesions. Image-enhanced endoscopy (IEE) increases lesion visibility by enhancing the microstructure, blood vessels, and mucosal surface color, resulting in the detection of colorectal lesions. In recent years, various IEE techniques have been used in clinical practice, each with its unique characteristics. Numerous studies have reported the effectiveness of IEE in the detection of colorectal lesions. IEEs can be divided into two broad categories according to the nature of the image: images constructed using narrowband wavelength light, such as narrowband imaging and blue laser imaging/blue light imaging, or color images based on white light, such as linked color imaging, texture and color enhancement imaging, and i-scan. Conversely, artificial intelligence (AI) systems, such as computer-aided diagnosis systems, have recently been developed to assist endoscopists in detecting colorectal lesions during colonoscopy. To better understand the features of each IEE, this review presents the effectiveness of each type of IEE and their combination with AI for colorectal lesion detection by referencing the latest research data.

Approaches and considerations in the endoscopic treatment of T1 colorectal cancer

“…Notable examples of electronic-based CE include NBI, i-scan, and flexible spectral imaging color enhancement (FICE). Imaging-enhanced endoscopy plays a crucial role in detecting and distinguishing neoplastic lesions, as well as predicting the DSI of T1 CRC [ 22 , 23 ]. The USMSTF recommends the proficient use of electronic-based CE, such as NBI, i-scan, FICE, or blue light imaging, as well as dye-based CE.…”

The Potential of Narrow-Band Imaging as a Novel Light Source for Photodynamic Therapy for Superficial Cancers via Endoscopes

“…IEE is a modality that enhances lesion visibility by intensifying microstructure, blood vessels, and color, resulting in easier detection of gastrointestinal lesions. Among IEE, three technologies are now available for visualizing microvascular imaging using narrow band via endoscopes, narrow-band imaging (NBI) (Olympus Medical Systems, Tokyo, Japan), blue laser imaging (BLI) (Fujifilm Co., Tokyo, Japan), and i-scan OE (PENTAX Medical, Tokyo, Japan) [ 14 ]. NBI utilizes the light of two distinct wavelengths: blue: λ = 390 - 445 nm, and green: λ = 530 - 550 nm [ 15 , 16 ].…”