Image Enhanced Endoscopy in Esophageal Squamous Cell Carcinoma

Esophageal Squamous Cell Carcinoma (ESCC) accounts for a significant portion of esophageal cancer cases worldwide, particularly in high-risk regions like China, Iran, and eastern Africa. It is often diagnosed at advanced stages, leading to poor prognosis and limited treatment options. Image-enhanced endoscopy enables precise visualization of abnormal mucosa, aiding in targeted biopsies for early detection of ESCC and reducing unnecessary sampling. Various techniques have emerged including lugol’s chromoendoscopy, narrow-band imaging, confocal laser endomicroscopy, and high-resolution microendoscopy. This article also discusses advancements in post-processing imaging technology and the novel role of Artificial Intelligence (AI) in improving diagnostic accuracy. While image enhanced endoscopy is promising, challenges such as training, standardization, and long-term validation remain. Implementing image enhanced endoscopy, combined with advancements in AI, has the potential to transform ESCC diagnosis and significantly improve patient outcomes, especially in high-risk populations.