Texture and color enhancement imaging in magnifying endoscopic evaluation of colorectal adenomas

BACKGROUNDOlympus Corporation has developed texture and color enhancement imaging (TXI) as a novel image-enhancing endoscopic technique.AIMTo investigate the effectiveness of TXI in identifying colorectal adenomas using magnifying observation.METHODSColorectal adenomas were observed by magnified endoscopy using white light imaging (WLI), TXI, narrow band imaging (NBI), and chromoendoscopy (CE). This study adopted mode 1 of TXI. Adenomas were confirmed by histological examination. TXI visibility was compared with the visibility of WLI, NBI, and CE for tumor margin, and vessel and surface patterns of the Japan NBI expert team (JNET) classification. Three expert endoscopists and three non-expert endoscopists evaluated the visibility scores, which were classified as 1, 2, 3, and 4.RESULTSSixty-one consecutive adenomas were evaluated. The visibility score for tumor margin of TXI (3.47 & PLUSMN; 0.79) was significantly higher than that of WLI (2.86 & PLUSMN; 1.02, P < 0.001), but lower than that of NBI (3.76 & PLUSMN; 0.52, P < 0.001), regardless of the endoscopist's expertise. TXI (3.05 & PLUSMN; 0.79) had a higher visibility score for the vessel pattern of JNET classification than WLI (2.17 & PLUSMN; 0.90, P < 0.001) and CE (2.47 & PLUSMN; 0.87, P < 0.001), but lower visibility score than NBI (3.79 & PLUSMN; 0.47, P < 0.001), regardless of the experience of endoscopists. For the visibility score for the surface pattern of JNET classification, TXI (2.89 & PLUSMN; 0.85) was superior to WLI (1.95 & PLUSMN; 0.79, P < 0.01) and CE (2.75 & PLUSMN; 0.90, P = 0.002), but inferior to NBI (3.67 & PLUSMN; 0.55, P < 0.001).CONCLUSIONTXI provided higher visibility than WLI, lower than NBI, and comparable to or higher than CE in the magnified observation of colorectal adenomas.