Abstract：
The efficacy of texture and color enhancement imaging (TXI) in the novel light-emitting diode endoscopic system for polyp detection has not been examined. We aimed to evaluate the noninferiority of the additional 30-second (Add-30-s) observation of the right-sided colon (cecum/ascending colon) with TXI compared with narrow band imaging (NBI) for detecting missed polyps.
We enrolled 381 patients ≥40 years old who underwent colonoscopy from September 2021 to June 2022 in 3 institutions and randomly assigned them to either the TXI or NBI groups. The right-sided colon was first observed with white light imaging in both groups. Second, after reinsertion from hepatic flexure to the cecum, the right-sided colon was observed with Add-30-s observation of either TXI or NBI. The primary endpoint was to examine the noninferiority of TXI to NBI using the mean number of adenomas and sessile serrated lesions per patient. The secondary ones were to examine adenoma detection rate, adenoma and sessile serrated lesions detection rates, and polyp detection rates in both groups.
The TXI and NBI groups consisted of 177 and 181 patients, respectively, and the noninferiorities of the mean number of adenomas and sessile serrated lesions per patients in the second observation were significant (TXI 0.29 [51/177] vs NBI 0.30 [54/181], P < 0.01). The change in adenoma detection rate, adenoma and sessile serrated lesions detection rate, and polyp detection rate for the right-sided colon between the TXI and NBI groups were not different (10.2%/10.5% [ P = 0.81], 13.0%/12.7% [ P = 0.71], and 15.3%/13.8% [ P = 0.71]), respectively.
Regarding Add-30-s observation of the right-sided colon, TXI was noninferior to NBI.
We enrolled 381 patients ≥40 years old who underwent colonoscopy from September 2021 to June 2022 in 3 institutions and randomly assigned them to either the TXI or NBI groups. The right-sided colon was first observed with white light imaging in both groups. Second, after reinsertion from hepatic flexure to the cecum, the right-sided colon was observed with Add-30-s observation of either TXI or NBI. The primary endpoint was to examine the noninferiority of TXI to NBI using the mean number of adenomas and sessile serrated lesions per patient. The secondary ones were to examine adenoma detection rate, adenoma and sessile serrated lesions detection rates, and polyp detection rates in both groups.
The TXI and NBI groups consisted of 177 and 181 patients, respectively, and the noninferiorities of the mean number of adenomas and sessile serrated lesions per patients in the second observation were significant (TXI 0.29 [51/177] vs NBI 0.30 [54/181], P < 0.01). The change in adenoma detection rate, adenoma and sessile serrated lesions detection rate, and polyp detection rate for the right-sided colon between the TXI and NBI groups were not different (10.2%/10.5% [ P = 0.81], 13.0%/12.7% [ P = 0.71], and 15.3%/13.8% [ P = 0.71]), respectively.
Regarding Add-30-s observation of the right-sided colon, TXI was noninferior to NBI.
摘要：
背景：尚未检查用于息肉检测的新型发光二极管（LED）内窥镜系统中的纹理和颜色增强成像（TXI）的功效。我们旨在评估与窄带成像（NBI）相比，用TXI对右侧结肠（盲肠/升结肠）进行额外30秒（Add-30-s）观察的非劣效性。
方法：我们在三个机构中招募了2021年9月至2022年6月接受结肠镜检查的381名年龄≥40岁的患者，并将他们随机分配到TXI或NBI组。在两组中首先用白光成像(WLI)观察右侧结肠。其次,从肝曲重新插入盲肠后，用TXI或NBI的Add-30-s观察观察右侧结肠。主要终点是使用每个患者的腺瘤和无柄锯齿状病变（SSL）的平均数量（MASP）来检查TXI对NBI的非劣效性。其次是检查腺瘤检出率(ADR)，腺瘤，和SSL检测率(ASDR)，两组的息肉检出率（PDR）。
结果：TXI和NBI组包括177和181名患者，分别,第二次观察中MASPs的非劣性是显着的（TXI0.29（51/177）与NBI0.30（54/181），p<0.01)。ADR的变化，ASDR,TXI组和NBI组之间右侧结肠的PDR没有差异（10.2％/10.5％（p=0.81），13.0%/12.7%（p=0.71），和15.3%/13.8%(p=0.71)，分别。
结论：关于右侧结肠的add-30-s观察，TXI不劣于NBI。
方法：我们在三个机构中招募了2021年9月至2022年6月接受结肠镜检查的381名年龄≥40岁的患者，并将他们随机分配到TXI或NBI组。在两组中首先用白光成像(WLI)观察右侧结肠。其次,从肝曲重新插入盲肠后，用TXI或NBI的Add-30-s观察观察右侧结肠。主要终点是使用每个患者的腺瘤和无柄锯齿状病变（SSL）的平均数量（MASP）来检查TXI对NBI的非劣效性。其次是检查腺瘤检出率(ADR)，腺瘤，和SSL检测率(ASDR)，两组的息肉检出率（PDR）。
结果：TXI和NBI组包括177和181名患者，分别,第二次观察中MASPs的非劣性是显着的（TXI0.29（51/177）与NBI0.30（54/181），p<0.01)。ADR的变化，ASDR,TXI组和NBI组之间右侧结肠的PDR没有差异（10.2％/10.5％（p=0.81），13.0%/12.7%（p=0.71），和15.3%/13.8%(p=0.71)，分别。
结论：关于右侧结肠的add-30-s观察，TXI不劣于NBI。
