Physics

Internal medicine

Radiology

Colonoscopy

Withdrawal time

Colorectal cancer

Gastroenterology

Optics

Cancer

Logistic regression

Adenoma

Colorectal adenoma

Ascending colon

White light

Confidence interval

Medicine

Digestive Endoscopy

Objectives We aimed to evaluate the efficacy of texture and color enhancement imaging (TXI), which allows the acquisition of brighter images with enhanced color and surface structure in colorectal polyp detection compared to white light imaging. Methods Patients who underwent colonoscopy with repeated ascending colon observation using TXI and white light imaging between August 2020 and January 2021 were identified in three institutions. The outcomes included the mean number of adenomas detected per procedure (MAP), adenoma detection rate (ADR), and ascending colonic adenoma miss rate (Ac‐AMR). Logistic regression was used to determine the effects of the variables on the outcomes. Results We included 1043 lesions from 470 patients in the analysis. The MAP, ADR, flat polyp detection rate, and Ac‐AMR in TXI and white light imaging were 1.5% (95% confidence interval 1.3–1.6%) vs. 1.0% (0.9–1.1%), 58.2% (51.7–64.6%) vs. 46.8% (40.2–53.4%), 66.2% (59.8–72.2%) vs. 49.8% (43.2–56.4%), and 17.9% (12.1–25.2%) vs. 28.2% (20.0–37.6%), respectively. TXI, age, withdrawal time, and endoscopy type were identified as significant factors affecting the MAP and the ADR using multivariate regression analysis. Conclusions Our study indicates that TXI improve the detection of colorectal neoplastic lesions. However, prospective randomized trials are required to confirm these findings.

Detection of colorectal adenomas with texture and color enhancement imaging: Multicenter observational study