Assessing the Effectiveness of Texture and Color Enhancement Imaging (TXI) versus White-Light Endoscopy (WLE) in Detecting Gastrointestinal Lesions: A Comprehensive Meta-Analysis

Document Type

Conference Proceeding

Publication Date

10-1-2024

Publication Title

Am J Gastroenterol

Abstract

Introduction: Texture and Color Enhancement Imaging (TXI) is an innovative technology introduced by Olympus in the EVIS X1 endoscopy system. It enhances mucosal visualization and increases polyp detection rates without compromising the brightness or color spectrum of white-light endoscopy (WLE). This meta-analysis assesses TXI's effectiveness in detecting gastrointestinal (GI) lesions compared to WLE, aiming to evaluate TXI's clinical utility. Methods: This meta-analysis adhered to Cochrane guidelines and PRISMA standards, comparing TXI versus WLE for GI lesions. A comprehensive search across PubMed, MEDLINE, Embase, Scopus, and CENTRAL up to May 2024 included RCTs and observational studies of patients undergoing endoscopy. Data extraction followed PICOS criteria using Excel, and statistical analyses were conducted with RevMan using a random-effects model, with significance at P < 0.05. Results: From 2,000 screened studies, 17 studies encompassing 15,929 patients undergoing endoscopic procedures were selected. The TXI group included 3,944 patients, while the WLE group had 11,985 patients. The primary outcomes demonstrated significant enhancements with TXI, specifically in the color difference between lesions and surrounding mucosa (Mean difference [MD]: 3.55; 95% CI: 2.63, 4.46) and the visibility score of lesions (MD: 0.42; 95% CI: 0.21, 0.63). Secondary outcomes revealed a marked increase in the adenoma detection rate (ADR) (Odds ratio [OR]: 1.84; 95% CI: 1.52, 2.22). Additionally, TXI showed superior efficacy in polypoid ADR (OR: 1.66; 95% CI: 1.31, 2.12) and visibility scores stratified by lesion characteristics, including vessel pattern (MD: 0.75; 95% CI: 0.47, 1.03), surface pattern (MD: 0.82; 95% CI: 0.60, 1.04), and margin pattern (MD: 0.55; 95% CI: 0.23, 0.87). Furthermore, visibility scores for sessile serrated lesions (SSL) and hyperplastic polyps (HP) (MD: 0.58; 95% CI: 0.15, 1.01), along with the mean adenoma detection rate per procedure (MD: 0.64; 95% CI: 0.32, 0.95), demonstrated significant improvement with TXI. Conclusion: This meta-analysis provides compelling evidence supporting the superiority of Texture and Color Enhancement Imaging (TXI) over White-Light Endoscopy (WLE) in detecting gastrointestinal lesions. The significant improvements in color differentiation, visibility scores, and adenoma detection rates underscore TXI's value as a powerful tool for endoscopic procedures, offering a promising advancement in gastrointestinal imaging (see Table 1).

Volume

119

Issue

10

First Page

S638

Last Page

S639

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