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Review
. 2025 Sep 2.
doi: 10.1007/s12664-025-01850-z. Online ahead of print.

Image-enhanced endoscopy in upper GI tract: State-of-the-art review

Zaheer Nabi  1 , Sonmoon Mohapatra  2 , Noriya Uedo  3 , Ashutosh Mohapatra  2 , Pradev Inavolu  4 , Hardik Rughwani  5   4 , Mohan Ramchandani  4 , D Nageshwar Reddy  5   4
Affiliations
Review

Image-enhanced endoscopy in upper GI tract: State-of-the-art review

Zaheer Nabi et al. Indian J Gastroenterol. .

Abstract

Early and accurate identification of upper gastrointestinal (GI) malignancies remains a cornerstone for improving clinical outcomes. Conventional white light endoscopy, although the standard diagnostic modality, often fails to detect subtle premalignant and early neoplastic changes. Image-enhanced endoscopy (IEE) addresses these limitations by improving visualization of surface structures and vascular patterns. Despite its proven diagnostic value, IEE remains underutilized in resource-limited settings, largely due to lack of training and standardization. Adoption of structured training programs and digital learning tools could help bridge these gaps and enhance the detection of early GI neoplasms. This comprehensive review outlines the clinical utility of IEE in upper GI endoscopy, with a particular focus on narrow band imaging. Practical tips for usage are provided on equipment selection, procedural preparation and standardized examination techniques such as the Systematic Screening Protocol for the Stomach (SSS). Pre-medications, use of soft black hoods and anti-peristaltic agents are highlighted as critical adjuncts for optimizing visualization.

Keywords: Endoscopy; Narrow band imaging; Neoplasms; Upper gastrointestinal.

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Conflict of interest statement

Declarations. Conflict of interest: ZN, SM, NU, AM, PI, HR, MR and DNR declare no competing interests. Human ethics: Not applicable. Consent to participate: Not applicable. Consent for publication: All authors have reviewed and approved the final version of the manuscript and consent to its submission and publication. Disclaimer: The authors are solely responsible for the data and the contents of the paper. In no way, the Honorary Editor-in-Chief, Editorial Board Members, the Indian Society of Gastroenterology or the printer/publishers are responsible for the results/findings and content of this article.

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