Utility of texture and color enhancement and red dichromatic imaging during endoscopic resection.

Background and Aims: There has been remarkable progress to improve the quality of white-light imaging with the introduction of image-enhanced endoscopy (IEE). Texture and color enhancement imaging (TXI) and red dichromatic imaging (RDI) are promising novel IEE techniques. In this report, we provide an overview of these technologies and their clinical applications. Methods: The IEE modes can be activated on the EVIS X1 video processor system (Olympus Corporation, Tokyo, Japan) during the endoscopic procedure. We present cases in which texture and color enhancement and RDI modalities are used in real time. Results: We demonstrate cases in which these novel IEE modes (1) helped enhance the surface structure of a colonic lesion during optical diagnosis, (2) improved demarcation of the normal mucosa and neoplastic lesion during snare resection of a duodenal polyp, (3) delineated submucosal structures and muscle layer during endoscopic submucosal dissection, and (4) enhanced visualization of blood vessels for prophylactic hemostasis and management of active bleeding during endoscopic resection. Conclusions: This video review provides a general overview of both TXI and RDI during endoscopic resection of gastrointestinal neoplasia. Future studies are needed to corroborate the current evidence on these IEE modalities and further define their potential applications across various endoscopic procedures.