Texture and Color Enhancement Feature on New Olympus Scopes Improved Detection

Texture and Color Enhancement Feature on New Olympus Scopes Improved Detection

Douglas K. Rex, MD, MASGE, reviewing Antonelli G, et al. Endoscopy 2023 Sep 7.

Texture and color enhancement imaging (TXI) is a new image-processing feature on the latest generation of Olympus colonoscopes (Tokyo, Japan). These instruments have been commercially available in Europe for a few years but are not yet available in the U.S. The TXI image is similar to white-light imaging (WLI), but texture, color, and brightness are all electronically enhanced.

In a European and Japanese multinational randomized trial, 747 patients underwent colonoscopy with TXI or WLI. The adenoma detection rate (ADR) included patients with any conventional adenoma, sessile serrated lesion (SSL), or cancer. Among the study population, the purpose of colonoscopy was primary screening or surveillance in 40%, a positive fecal immunochemical test in 45%, and GI symptoms in 16%.

The ADR was 58.9% with TXI versus 42.7% with WLI. TXI detection was higher for 1- to 5-mm and 6- to 9-mm lesions and in both the proximal and distal colon. The detection of adenomas per colonoscopy was also higher with TXI at 1.36 versus 0.89. The prevalence of SSLs with TXI was similar at 12.0% versus 9.1% with WLI (P=.21).

Douglas K. Rex, MD, FASGE


This is the first major trial to evaluate the impact of TXI on detection, and the result is very positive.


Note to readers: At the time we reviewed this paper, its publisher noted that it was not in final form and that subsequent changes might be made.


Antonelli G, Bevivino G, Pecere S, et al. Texture and color enhancement imaging versus high definition white-light endoscopy for detection of colorectal neoplasia: a randomized controlled trial. Endoscopy 2023 Sep 7. (Epub ahead of print) (https://doi.org/10.1055/a-2129-7254)


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