Abstract
Background. i-scan is a software-driven technology that allows modifications of sharpness, hue, and contrast to enhance mucosal imaging. It uses postimage acquisition software with real-time mapping technology embedded in the endoscopic processor. Aims. To review applications of i-scan technology in clinical endoscopic practice. Methods. This is a case series of 20 consecutive patients who underwent endoscopic procedures where i-scan image enhancement algorithms were applied. The main outcome measures were to compare mucosal lesions with high-definition white light endoscopy (HD-WLE) and i-scan image enhancement for the application of diagnostic sampling and therapy. Results. 13 cases involving the upper GI tract and 7 cases of the lower GI tract are included. For upper GI tract pathology i-scan assisted in diagnosis or therapy of Barrett's esophagus with dysplasia, esophageal adenocarcinoma, HSV esophagitis, gastric MALT lymphoma, gastric antral intestinal metaplasia with dysplasia, duodenal follicular lymphoma, and a flat duodenal adenoma. For lower GI tract pathology i-scan assisted in diagnosis or therapy of right-sided serrated adenomas, flat tubular adenoma, rectal adenocarcinoma, anal squamous cell cancer, solitary rectal ulcer, and radiation proctitis. Conclusions. i-scan imaging provides detailed topography of mucosal surfaces and delineates lesion edges, which can directly impact endoscopic management.
Highlights
As the field of gastrointestinal endoscopy continues to advance, various methods to enhance mucosal imaging continue to be developed and applied
We report a series of 20 cases from a single academic tertiary care hospital where i-scan technology significantly impacted the management of patients in a wide variety of clinical scenarios
There is an increasing demand for improving mucosal imaging as a means to identify pathology and target diagnostic sampling and guide endoscopic therapy. This has resulted in the development of technology-based methods for enhancing mucosal imaging
Summary
As the field of gastrointestinal endoscopy continues to advance, various methods to enhance mucosal imaging continue to be developed and applied. Diagnostic and Therapeutic Endoscopy resolution of 1.25 megapixels per image, which allows for analysis and modification of the per pixel luminosity data It does so by using various combinations of three software algorithms: surface enhancement (SE), contrast enhancement (CE), and tone enhancement (TE). Contrast enhancement slightly suppresses red and green wavelength components of the white light image, while adding a minute blue hue to darker or more depressed areas of mucosa to allow for detailed observation of subtle mucosal irregularities. This helps define “peaks and valleys” within the mucosal surface, resulting in a more detailed topography of the mucosal surface. We report a series of 20 cases from a single academic tertiary care hospital where i-scan technology significantly impacted the management of patients in a wide variety of clinical scenarios
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