The fundamental approach to endoscopy is to identify concerning and potentially premalignant lesions in the gastrointestinal tract, sample or resect the area of interest, await histologic results, and subsequently formulate a treatment and/or surveillance strategy. Detecting subtle lesions and deciding whether they are clinically significant are challenges that rely on the endoscopist's observation skills and experience. Enhanced imaging technologies have been developed to aid in lesion identification and classification, enabling better visualization of the lumen from a wide-field view while also enabling real-time near-field, including cellular level, imaging of the tissue. These innovations can potentially help reduce the rate of missed lesions, the need for extensive surveillance biopsies, and the frequency of surveillance. Several of these advanced imaging technologies are discussed in this review.
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