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.