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Letter to the Editor Image-Enhanced Endoscopy for Diagnosis and Treatment of Gastrointestinal Tumor
Viroj Wiwanitkit,,,, Kyoung Oh Kim, Yang Suh Ku
Clinical Endoscopy 2013;46(4):423-424.
DOI: https://doi.org/10.5946/ce.2013.46.4.423
Published online: July 31, 2013

Hainan Medical University, Haikou, China.

University of Nis Faculty of Medicine, Niš, Serbia.

Joseph Ayo Babalola University, Ikeji-Arakeji, Nigeria.

Chulalongkorn University, Bangkok, Thailand.

Correspondence: Viroj Wiwanitkit, Wiwanitkit House, Bangkhae, Bangkok 10160, Thailand. Tel: +66-24-132436, Fax: +66-24-132436, wviroj@yahoo.com
• Received: June 18, 2013   • Accepted: July 23, 2013

Copyright © 2013 Korean Society of Gastrointestinal Endoscopy

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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To the Editor:
Sir, the recent report on mage-enhanced endoscopy for diagnosis and treatment of gastrointestinal tumor is very interesting.1 Kim and Ku1 noted that the usefulness of these image enhanced endoscopy has not been proven yet, although there are several studies reporting diagnostic superiority of these new imaging methods over white light endoscopy. In fact, the new image-enhanced endoscopy has several advantages. The better visualization can help physician better manipulate the gastrointestinal tumor.2 However, there are some points to be considered. First, there is no systematic evaluation on the cost effectiveness of this new technique comparing to the classical technique. Nishida et al.3 noted and called for the evaluation of the safety and cost effectiveness of this new technique.

The author has no financial conflicts of interest.

  • 1. Kim KO, Ku YS. Is image-enhanced endoscopy useful for the diagnosis and treatment of gastrointestinal tumor? Clin Endosc 2013;46:248–250. 23767035.ArticlePubMedPMCPDF
  • 2. Sonbare D. Image-enhanced laparosocopy: would it change staging and management protocols in surgical oncology. Surgery 2012;152:939–940. 22902200.ArticlePubMedPMC
  • 3. Nishida T, Tsutsui S, Kato M, et al. Treatment strategy for gastric noninvasive intraepithelial neoplasia diagnosed by endoscopic biopsy. World J Gastrointest Pathophysiol 2011;2:93–99. 22180842.ArticlePubMedPMCPDF
To the Editor:
We thank Wiwanitkit for the comment.1 As Professor Wiwanitkit said, there are several studies reporting diagnostic superiority of these new imaging methods over white light endoscopy.2-4 However, most of these studies were not based on objective assessments and there was a lack of objective evidence. Although some experts suggest several diagnostic criteria for Barrett's esophagus, precancerous and cancerous lesions with new imaging techniques,5-8 these diagnostic criteria are not standardized and not verified by studies of interobserver reliability. There is no consensus on these diagnostic criteria. Probably these new imaging methods are expected to improve the quality of endoscopic diagnosis; however, there are some drawbacks to be overcome. In order for the new imaging modalities to be helpful in the diagnosis, as we mentioned in the conclusion, there needs to be a standardized diagnostic criteria established through a consensus meeting with interobserver reliability studies. The issue of cost-effectiveness comes later.

The authors have no financial conflicts of interest.

  • 1. Kim KO, Ku YS. Is image-enhanced endoscopy useful for the diagnosis and treatment of gastrointestinal tumor? Clin Endosc 2013;46:248–250. 23767035.ArticlePubMed
  • 2. Sonbare D. Image-enhanced laparosocopy: would it change staging and management protocols in surgical oncology. Surgery 2012;152:939–940. 22902200.ArticlePubMed
  • 3. Nishida T, Tsutsui S, Kato M, et al. Treatment strategy for gastric noninvasive intraepithelial neoplasia diagnosed by endoscopic biopsy. World J Gastrointest Pathophysiol 2011;2:93–99. 22180842.ArticlePubMed

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