Early detection of early gastric cancer using image-enhanced endoscopy: Current trends

Image-enhanced endoscopy refers to techniques of enhancing mucosa surface contrast with the ultimate aim of improving lesion detection and diagnosis. It is vital to detect early gastric cancer as it may be possible to perform curative endoscopic resection. In this topic review, we summarize the options available, such as the traditional dye-based chromoendoscopy, as well as the newer equipment-based techniques such as narrow-band imaging, flexible spectral imaging color enhancement, and i-scan. We further discuss in greater detail the technique of narrow-band imaging combined with magnifying endoscopy, and how this has facilitated lesion characterization and diagnosis based on characteristic abnormal microvascular and microsurface features. Other endoscopic imaging modalities such as autofluorescence imaging and endoscopic microscopy are also briefly discussed.