Judge Ciaran, Law David, Jones Glynis, Picardo Sherman, Ragunath Krish
Department of Gastroenterology Royal Perth Hospital Perth Australia.
South Metropolitan Health Service, Fiona Stanley Hospital Library and Information Service for East and South Metropolitan Health Services Murdoch Australia.
JGH Open. 2025 Aug 17;9(8):e70191. doi: 10.1002/jgh3.70191. eCollection 2025 Aug.
Image enhanced endoscopy (IEE) can augment the detection of colorectal cancer (CRC) and its precursor lesions, potentially reducing incidence and mortality. Early data on texture and color enhancement imaging (TXI) support its use for neoplasia screening. This study aimed to systematically review and perform a meta-analysis to assess the impact of TXI on colonic adenoma detection.
The systematic review and meta-analysis followed PRISMA guidelines. Studies comparing TXI with white light imaging (WLI) were eligible for inclusion. Searches were conducted through relevant databases and major conferences up to July 1, 2024. The primary outcome was ADR, with secondary outcomes including polyp detection rate (PDR), mean number of adenomas per patient (MAP), and size, location, morphology, and withdrawal time.
From 1270 results, 4 studies were included in the meta-analysis ( = 5481). TXI significantly increased ADR compared to WLI (55.8% vs. 47.8%, RR 1.24, < 0.001), PDR (63.7% vs. 54.7%, RR 1.23, < 0.001), and MAP (mean difference 0.41, = 0.005). and improved detection of proximal lesions (MD 0.21, 95% CI [0.15-0.27], < 0.001, = 0%). Pooled withdrawal times were not different between groups, with no differences between endoscopist experience or quality of bowel preparation, where reported. Sub-analysis further demonstrated superiority of TXI, with an absolute difference in ADR of 14.2%.
TXI significantly improves ADR, PDR, and MAP compared to WLI, highlighting its potential to enhance CRC screening efficacy without impact from user experience, bowel prep, or withdrawal times. TXI is a useful and practical adjunct to enhance the detection of colonic neoplasia.
图像增强内镜检查（IEE）可提高结直肠癌（CRC）及其前驱病变的检出率，有可能降低发病率和死亡率。关于纹理和颜色增强成像（TXI）的早期数据支持其用于肿瘤筛查。本研究旨在系统评价并进行荟萃分析，以评估TXI对结肠腺瘤检测的影响。
系统评价和荟萃分析遵循PRISMA指南。比较TXI与白光成像（WLI）的研究符合纳入标准。通过相关数据库和主要会议进行检索，截至2024年7月1日。主要结局为腺瘤检出率（ADR），次要结局包括息肉检出率（PDR）、每名患者腺瘤的平均数量（MAP）以及大小、位置、形态和退镜时间。
从1270项结果中，4项研究纳入荟萃分析（n = 5481）。与WLI相比，TXI显著提高了ADR（55.8%对47.8%，RR 1.24，P < 0.001）、PDR（63.7%对54.7%，RR 1.23，P < 0.001）和MAP（平均差异0.41，P = 0.005），并改善了近端病变的检测（MD 0.21，95%CI[0.15 - 0.27]，P < 0.001，I² = 0%）。各研究组的汇总退镜时间无差异，在内镜医师经验或肠道准备质量方面（如报告所述）也无差异。亚组分析进一步证明了TXI的优越性，ADR的绝对差异为14.2%。
与WLI相比，TXI显著提高了ADR、PDR和MAP，突出了其在不受到用户经验、肠道准备或退镜时间影响的情况下提高CRC筛查效果的潜力。TXI是增强结肠肿瘤检测的一种有用且实用的辅助手段。
