Esophageal Squamous Cell Carcinoma Under Iodine Staining

According to a study published in DEN Open, texture and color enhancement imaging (TXI) significantly enhances the visibility of esophageal squamous cell carcinoma (ESCC) lesions after iodine staining compared to white light imaging (WLI).

Researchers aimed to evaluate the effects of TXI on improving the endoscopic visibility of ESCC under iodine staining. Twenty ESCC lesions that underwent endoscopic submucosal dissection were retrospectively analyzed. The study assessed the color difference (ΔEe) between ESCC and surrounding mucosa using WLI, TXI, and narrow-band imaging (NBI). Additionally, ΔEe was measured under 1% iodine staining with both WLI and TXI. Endoscopists also evaluated the visibility grade of each imaging modality.

Results showed that the median ΔEe was significantly higher on TXI compared to WLI (14.53 vs 10.71; P < 0.005). Under iodine staining, the median ΔEe on TXI was substantially higher than both TXI and NBI without staining (39.20 vs 14.53 vs 16.42; P < 0.005 for both comparisons). A positive correlation in ΔEe under iodine staining was found between TXI and WLI (correlation coefficient = 0.61, P < 0.01). Moreover, for each lesion, the ΔEe under iodine staining was greater on TXI than on WLI. Endoscopists also rated the visibility grade of ESCC significantly higher on TXI than on WLI under iodine staining (P < 0.01).

These findings suggest that TXI could improve the detection and delineation of ESCC during endoscopic examinations, potentially leading to better clinical outcomes.

Reference
Kato T, Hikichi T, Nakamura J, et al. Visibility of esophageal squamous cell carcinoma under iodine staining on texture and color enhancement imaging. DEN Open. Published online May 8, 2024. doi:10.1002/deo2.370