TEXTURE AND COLOR ENHANCING IMAGING (TXI) INCREASES ADENOMA DETECTION RATE IN COLONOSCOPY: INTERIM ANALYSIS OF A RANDOMIZED CONTROLLED TRIAL

Aims Virtual chromoendoscopy techniques to enhance imaging during colonoscopy have shown controversial results in increasing Adenoma Detection Rate (ADR). A new imaging modality, Texture and Color Enhancing Imaging (TXI, Exera X1, Olympus, Japan) was recently proposed as a substitute to standard white light (WLI) colonoscopy. We performed an interim analysis of an ongoing multicenter, randomized trial to assess the efficacy of TXI in detection of colorectal neoplasia.

Methods We enrolled consecutive patients>40 years old undergoing screening, surveillance or diagnostic colonoscopies at 4 centers (Italy, Germany, Japan) from September through December 2021. Patients were randomly assigned (1:1) to groups undergoing colonoscopies with TXI or WLI (controls). The primary outcome was adenoma detection rate (ADR, the percentage of patients with at least 1 histologically proven adenoma or carcinoma). Secondary outcomes were adenomas detected per colonoscopy (APC), and withdrawal time. Odds Ratios (OR), adjusted for age, sex and colonoscopy indication were calculated.

Results We currently enrolled 536 patients (9 expert endoscopists) out of a total expected of 800 (age: 62.9±9.08 years old; gender M/F: 330/268). ADR was statistically significantly higher in the TXI group (153/268, 57.1%) than in the WLI group (113/268, 42.2%; adjusted OR: 2.0; 95%CI:1.39 to 1.89), as well as APC (1.53; 95%CI:1.29-1.71 vs 1.04; 95%CI:0.88- 1.22). No statistically significant difference in withdrawal time (TXI: 7.76±2.09 minutes vs WLI: 8.07±1.78; p=ns) was observed.

Conclusions In an interim analysis of a multicenter, randomized trial, we found that the new TXI imaging modality increases ADR and adenomas detected per colonoscopy.

Publication History

Article published online:
14 April 2022