Efficacy of image-enhanced endoscopy for colorectal polyp detection

Colonoscopy plays a key role in reducing the incidence and mortality of colorectal cancer by detecting precancerous lesions, such as adenomas. Image-enhanced endoscopy (IEE) has been reported to effectively improve lesion detection and characterization in many cases. With the development of new endoscopic instruments, the IEE technology is rapidly advancing, and new endoscopes using light-emitting diode light sources, in addition to xenon and laser light sources, have been introduced, and various types of IEEs are used. Several observational methods have been validated for detecting and preventing missed lesions, such as narrow-band imaging (NBI), blue laser/light imaging (BLI), linked color imaging, and texture and color enhancement imaging, which have been suggested to be more effective than white light observation. The Japan NBI Expert Team classification, a unified classification of NBI magnification developed in Japan, can be used alongside NBI and BLI magnification to evaluate surface and vessel patterns and diagnose lesions. In this review, we describe the usefulness of each IEE with reference to the latest data.