Retrospective Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Feb 16, 2022; 14(2): 96-105
Published online Feb 16, 2022. doi: 10.4253/wjge.v14.i2.96
Texture and color enhancement imaging in magnifying endoscopic evaluation of colorectal adenomas
Osamu Toyoshima, Toshihiro Nishizawa, Shuntaro Yoshida, Tomoharu Yamada, Nariaki Odawara, Tatsuya Matsuno, Miho Obata, Ken Kurokawa, Chie Uekura, Mitsuhiro Fujishiro
Osamu Toyoshima, Toshihiro Nishizawa, Shuntaro Yoshida, Tomoharu Yamada, Nariaki Odawara, Tatsuya Matsuno, Miho Obata, Ken Kurokawa, Chie Uekura, Gastroenterology, Toyoshima Endoscopy Clinic, Tokyo 157-0066, Japan
Toshihiro Nishizawa, Department of Gastroenterology and Hepatology, International University of Health and Welfare, Narita Hospital, Narita 286-8520, Chiba, Japan
Tomoharu Yamada, Nariaki Odawara, Tatsuya Matsuno, Miho Obata, Ken Kurokawa, Chie Uekura, Mitsuhiro Fujishiro, Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan
Author contributions: Toyoshima O contributed to conception of article, drafted the article, took endoscopic images, reviewed the endoscopic images, did statistical analysis, and approved final manuscript; Nishizawa T contributed to conception of article, drafted the article, reviewed the endoscopic images, and approved final manuscript; Yoshida S, Yamada T, Matsuno T, and Odawara N reviewed the endoscopic images, critically reviewed, and approved final manuscript; Obata M, Kurokawa K, Uekura C, and Fujishiro M contributed to critical review and approved final manuscript.
Institutional review board statement: This study was reviewed and approved by the Certificated Review Board, Yoyogi Mental Clinic on July 16, 2021 (approval no. RKK227).
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent. For full disclosure, the details of the study are published on the home page of Toyoshima Endoscopy Clinic.
Conflict-of-interest statement: Fujishiro M received research grant and honoraria from Olympus Corporation.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Toshihiro Nishizawa, MD, PhD, Professor, Department of Gastroenterology and Hepatology, International University of Health and Welfare, Narita Hospital, 852 Hatakeda, Narita 286-8520, Chiba, Japan. nisizawa@kf7.so-net.ne.jp
Received: August 15, 2021
Peer-review started: August 15, 2021
First decision: September 12, 2021
Revised: September 18, 2021
Accepted: January 6, 2022
Article in press: January 6, 2022
Published online: February 16, 2022
Processing time: 178 Days and 22.3 Hours
Abstract
BACKGROUND

Olympus Corporation has developed texture and color enhancement imaging (TXI) as a novel image-enhancing endoscopic technique.

AIM

To investigate the effectiveness of TXI in identifying colorectal adenomas using magnifying observation.

METHODS

Colorectal 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.

RESULTS

Sixty-one consecutive adenomas were evaluated. The visibility score for tumor margin of TXI (3.47 ± 0.79) was significantly higher than that of WLI (2.86 ± 1.02, P < 0.001), but lower than that of NBI (3.76 ± 0.52, P < 0.001), regardless of the endoscopist’s expertise. TXI (3.05 ± 0.79) had a higher visibility score for the vessel pattern of JNET classification than WLI (2.17 ± 0.90, P < 0.001) and CE (2.47 ± 0.87, P < 0.001), but lower visibility score than NBI (3.79 ± 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 ± 0.85) was superior to WLI (1.95 ± 0.79, P < 0.01) and CE (2.75 ± 0.90, P = 0.002), but inferior to NBI (3.67 ± 0.55, P < 0.001).

CONCLUSION

TXI provided higher visibility than WLI, lower than NBI, and comparable to or higher than CE in the magnified observation of colorectal adenomas.

Keywords: Texture and color enhancement imaging; Adenoma; Colonoscopy; Narrow band imaging; Japan NBI Expert Team; Olympus

Core Tip: Texture and color enhancement imaging (TXI) has been developed as a novel image-enhancing endoscopy. Colorectal adenomas were observed by magnified endoscopy using white light imaging (WLI), TXI, narrow band imaging (NBI), and chromoendoscopy (CE). 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. TXI provided higher visibility than WLI and lower than NBI for tumor margin. TXI showed higher visibility than WLI and CE, and lower than NBI for the vessel and surface patterns of the JNET classification.