Image Enhanced Endoscopy in Esophageal Squamous Cell Carcinoma

Shaleen Vasavada, Sharmila Anandasabapathy
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Abstract

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.
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影像增强内镜在食管鳞状细胞癌中的应用
食管鳞状细胞癌(ESCC)占全球食管癌病例的很大一部分,特别是在中国、伊朗和东非等高风险地区。它通常在晚期被诊断出来,导致预后不良和治疗选择有限。图像增强内窥镜能够精确显示异常粘膜,有助于早期发现ESCC的靶向活检,减少不必要的采样。各种技术已经出现,包括lugol色内窥镜、窄带成像、共聚焦激光内窥镜和高分辨率显微内窥镜。本文还讨论了后处理成像技术的进展以及人工智能(AI)在提高诊断准确性方面的新作用。虽然图像增强内窥镜很有前途,但训练、标准化和长期验证等挑战仍然存在。实施图像增强内窥镜检查,结合人工智能的进步,有可能改变ESCC的诊断,并显着改善患者的预后,特别是在高危人群中。
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