Image-enhanced endoscopy

White light endoscopy is a basic tool available to gastroenterologists since the early 1960s, when flexible endoscopy was first introduced. Since then, gastroenterologists have been able to diagnose and treat gastrointestinal diseases at earlier stages. However, recent studies have also highlighted the limitations and imperfect nature of white light endoscopy. Image-enhanced endoscopy (IEE) has been available for the past 10 years and has been validated by research and clinical trials. A specific combination of dye-based (Lugol's solution, indigo carmine) and equipment-based IEE (narrow band imaging, Fujinon Intelligence Color Enhancement, Pentax i-Scan) is indicated for use in the oropharynx, hypopharynx, esophagus, stomach, and colon. The main use is for detecting, diagnosing, and treating early dysplastic lesions found during screening or surveillance of high-risk patients (eg, Barrett's esophagus, inflammatory bowel disease, hereditary nonpolyposis colorectal cancer syndrome). Effective use of IEE can improve patient prognosis. In this review, we aim to give a concise review of the indications, supportive evidence, and practical guidelines for the use of IEE to improve current diagnostic and therapeutic capabilities.