Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan.
Division of Science and Technology for Endoscopy, National Cancer Center Hospital East, Chiba, Japan.
Dig Endosc. 2023 May;35(4):529-537. doi: 10.1111/den.14480. Epub 2022 Dec 20.
We aimed to evaluate the efficacy of texture and color enhancement imaging (TXI), which allows the acquisition of brighter images with enhanced color and surface structure in colorectal polyp detection compared to white light imaging.
Patients who underwent colonoscopy with repeated ascending colon observation using TXI and white light imaging between August 2020 and January 2021 were identified in three institutions. The outcomes included the mean number of adenomas detected per procedure (MAP), adenoma detection rate (ADR), and ascending colonic adenoma miss rate (Ac-AMR). Logistic regression was used to determine the effects of the variables on the outcomes.
We included 1043 lesions from 470 patients in the analysis. The MAP, ADR, flat polyp detection rate, and Ac-AMR in TXI and white light imaging were 1.5% (95% confidence interval 1.3-1.6%) vs. 1.0% (0.9-1.1%), 58.2% (51.7-64.6%) vs. 46.8% (40.2-53.4%), 66.2% (59.8-72.2%) vs. 49.8% (43.2-56.4%), and 17.9% (12.1-25.2%) vs. 28.2% (20.0-37.6%), respectively. TXI, age, withdrawal time, and endoscopy type were identified as significant factors affecting the MAP and the ADR using multivariate regression analysis.
Our study indicates that TXI improve the detection of colorectal neoplastic lesions. However, prospective randomized trials are required to confirm these findings.
我们旨在评估纹理增强成像（TXI）的疗效，与白光成像相比，TXI 可在检测结直肠息肉时获得更亮、色彩和表面结构增强的图像。
在三个机构中，我们鉴定了 2020 年 8 月至 2021 年 1 月期间接受过 TXI 和白光成像重复升结肠观察的结肠镜检查患者。结局包括每个程序的平均腺瘤检出数（MAP）、腺瘤检出率（ADR）和升结肠腺瘤漏诊率（Ac-AMR）。采用逻辑回归分析确定变量对结局的影响。
我们对 470 例患者的 1043 个病变进行了分析。TXI 和白光成像的 MAP、ADR、平坦息肉检出率和 Ac-AMR 分别为 1.5%（95%置信区间 1.3-1.6%）vs. 1.0%（0.9-1.1%）、58.2%（51.7-64.6%）vs. 46.8%（40.2-53.4%）、66.2%（59.8-72.2%）vs. 49.8%（43.2-56.4%）和 17.9%（12.1-25.2%）vs. 28.2%（20.0-37.6%）。多变量回归分析显示，TXI、年龄、退出时间和内镜类型是影响 MAP 和 ADR 的显著因素。
我们的研究表明 TXI 可提高结直肠肿瘤性病变的检出率。然而，需要前瞻性随机试验来证实这些发现。
