Use of i-scan Endoscopic Image Enhancement Technology in Clinical Practice to Assist in Diagnostic and Therapeutic Endoscopy: A Case Series and Review of the Literature
Table 1
Cases in which i-scan imaging highlighted mucosal abnormalities not as clearly seen with white light endoscopy and subsequently affected management.
Case no.
Diagnosis
i-scan mode
Mucosal image
Impact on management
Esophagus
BE with HGD
1, 3
Nodule of HGD
Targeted EMR
BE with LGD
1, 2
Nodule of LGD
Targeted EMR
BE with HGD
1, 2, 3
Nodularity with HGD
Targeted EMR
BE with HGD
1, 2
Nodularity with HGD
Targeted EMR
BE with HGD
1, 2, 3
Nodularity with HGD
Targeted EMR
Esophageal cancer
1, 2, 3
Accentuated abnormal tissue
Targeted EMR
HSV esophagitis
1, 2, 3
Deep ulcerations
Targeted biopsy
Stomach
Gastric MALT lymphoma
1, 3
Gastric folds mucosal abnormality
Targeted EMR
CAG with intestinal metaplasia and dysplasia
1, 2, 3
Highlighted gastric thickening and nodularity
Subtotal gastrectomy
Small intestine
Periampullary follicular lymphoma
1, 2
Identified extent of involvement
Prevented unnecessary ampullectomy
Duodenal adenoma with dysplasia
1, 2, 3
Highlighted flat polyp margins
Complete EMR
Grade 1-2 submucosal follicular lymphoma
1, 2
Highlighted lymphoid appearance
Targeted EMR and prevention of surgical excision
Low-grade follicular lymphoma
1, 2
Highlighted nodular area
Targeted biopsy
Colon and rectum
Serrated adenoma
1, 2
Margins of polyp
Polyp detection and polypectomy
Serrated adenoma
2
Accentuated borders of right-sided polyp
Complete polypectomy
Tubular adenoma
1, 2
Detailed border of polyp on fold
R hemicolectomy
Anal SCCa T1N0
1, 2
Identified mucosal abnormality in anal canal
Targeted Bx
Rectal adenocarcinoma T1N0
1, 2, 3
Identified borders of flat “depressed” rectal polyp
