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CC BY-NC-ND 4.0 · Endosc Int Open 2025; 13: a24749676
DOI: 10.1055/a-2474-9676
Review

Texture and color enhancement imaging versus white light imaging for the detection of colorectal adenomas: Systematic review and meta-analysis

Authors

  • Stefan Mitev 

    1   Gastroenterology Clinic, University Hospital St Ivan Rilski, Sofia, Bulgaria (Ringgold ID: RIN266309)

  • Humza Saeed 

    2   Gastroenterology, Rawalpindi Medical University, Rawalpindi, Pakistan (Ringgold ID: RIN123683)

  • Ch Faizan Rasheed

    2   Gastroenterology, Rawalpindi Medical University, Rawalpindi, Pakistan (Ringgold ID: RIN123683)

  • Abdullah 

    2   Gastroenterology, Rawalpindi Medical University, Rawalpindi, Pakistan (Ringgold ID: RIN123683)

  • Stefan Murvakov

    3   HPB Surgery and Transplantology, Military Medical Academy, Sofia, Bulgaria, Sofia, Bulgaria

  • Vassil Sirakov

    3   HPB Surgery and Transplantology, Military Medical Academy, Sofia, Bulgaria, Sofia, Bulgaria

  • Stefan Tchernodrinski

    4   Division of Academic Internal Medicine and Geriatrics, University of Illinois Chicago, Chicago, United States (Ringgold ID: RIN14681)

  • Zoya Spassova

    1   Gastroenterology Clinic, University Hospital St Ivan Rilski, Sofia, Bulgaria (Ringgold ID: RIN266309)
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Abstract

Background and study aims

Texture and color enhancement imaging (TXI) is a novel optical technology designed to improve visibility during endoscopy by highlighting subtle differences in morphology and color. This systematic review and meta-analysis aimed to determine whether TXI, compared with conventional white light imaging (WLI), can improve important colonoscopy quality indicators, specifically the adenoma detection rate (ADR) and adenomas per colonoscopy (APC).

Patients and methods

We searched PubMed, EMBASE, and the Cochrane Central for studies comparing TXI to WLI in patients undergoing colonoscopy for any indication. Risk ratios (RRs) and mean differences (MDs) were computed using a random-effects model.

Results

We included 1541 patients from three studies, of which two were randomized controlled trials (RCTs). TXI was used in 775 patients (50.3%). Indications for colonoscopy varied, including positive fecal immunochemical test (FIT), surveillance, and diagnostic workup for abdominal symptoms. In the pooled data, TXI significantly increased both ADR (57,8% versus 43.6%; RR 1.32; 95% confidence interval [CI] 1.20-1.46; P < 0.001; I2 = 0%) and APC (MD 0.50; 95% CI 0.37-0.64; P < 0.001; I2 = 0%), compared with WLI. Furthermore, TXI was more effective at detecting nonpolypoid/flat adenomas, proximal/right-sided adenomas, and adenomas ≥ 10 mm in size. Colonoscopies with TXI had shorter withdrawal times.

Conclusions

Our meta-analysis demonstrates that TXI significantly improves detection of colorectal adenomas in patients undergoing colonoscopy for various indications. TXI has the potential to improve overall quality of colonoscopy and contribute to colorectal cancer prevention.

Keywords

Endoscopy Lower GI Tract - Diagnosis and imaging (inc chromoendoscopy, NBI, iSCAN, FICE, CLE...) - Polyps / adenomas / ... - Colorectal cancer

Supplementary Material



Publikationsverlauf

Eingereicht: 16. Juli 2024

Angenommen nach Revision: 13. November 2024

Accepted Manuscript online:
18. November 2024

Artikel online veröffentlicht:
13. Januar 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

Bibliographical Record
Stefan Mitev, Humza Saeed, Ch Faizan Rasheed, Abdullah, Stefan Murvakov, Vassil Sirakov, Stefan Tchernodrinski, Zoya Spassova. Texture and color enhancement imaging versus white light imaging for the detection of colorectal adenomas: Systematic review and meta-analysis. Endosc Int Open 2025; 13: a24749676.
DOI: 10.1055/a-2474-9676
 

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