Editorial
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Apr 14, 2024; 30(14): 1934-1940
Published online Apr 14, 2024. doi: 10.3748/wjg.v30.i14.1934
Topic highlight on texture and color enhancement imaging in gastrointestinal diseases
Osamu Toyoshima, Toshihiro Nishizawa, Keisuke Hata
Osamu Toyoshima, Department of 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, Japan
Keisuke Hata, Department of Gastroenterology, Nihonbashi Muromachi Mitsui Tower Midtown Clinic, Tokyo 103-0022, Japan
Author contributions: Toyoshima O, Nishizawa T, and Hata K contributed to this paper; Toyoshima O contributed to the design, writing of the manuscript, and review of literature; Nishizawa T and Hata K contributed to the design, discussion, and editing the manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
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: Osamu Toyoshima, MD, PhD, Director, Doctor, Department of Gastroenterology, Toyoshima Endoscopy Clinic, 6-17-5, Seijo, Setagaya-ku, Tokyo 157-0066, Japan. t@ichou.com
Received: November 30, 2023
Peer-review started: November 30, 2023
First decision: February 2, 2024
Revised: February 3, 2024
Accepted: March 25, 2024
Article in press: March 25, 2024
Published online: April 14, 2024
Abstract

Olympus Corporation developed texture and color enhancement imaging (TXI) as a novel image-enhancing endoscopic technique. This topic highlights a series of hot-topic articles that investigated the efficacy of TXI for gastrointestinal disease identification in the clinical setting. A randomized controlled trial demonstrated improvements in the colorectal adenoma detection rate (ADR) and the mean number of adenomas per procedure (MAP) of TXI compared with those of white-light imaging (WLI) observation (58.7% vs 42.7%, adjusted relative risk 1.35, 95%CI: 1.17-1.56; 1.36 vs 0.89, adjusted incident risk ratio 1.48, 95%CI: 1.22-1.80, respectively). A cross-over study also showed that the colorectal MAP and ADR in TXI were higher than those in WLI (1.5 vs 1.0, adjusted odds ratio 1.4, 95%CI: 1.2-1.6; 58.2% vs 46.8%, 1.5, 1.0-2.3, respectively). A randomized controlled trial demonstrated non-inferiority of TXI to narrow-band imaging in the colorectal mean number of adenomas and sessile serrated lesions per procedure (0.29 vs 0.30, difference for non-inferiority -0.01, 95%CI: -0.10 to 0.08). A cohort study found that scoring for ulcerative colitis severity using TXI could predict relapse of ulcerative colitis. A cross-sectional study found that TXI improved the gastric cancer detection rate compared to WLI (0.71% vs 0.29%). A cross-sectional study revealed that the sensitivity and accuracy for active Helicobacter pylori gastritis in TXI were higher than those of WLI (69.2% vs 52.5% and 85.3% vs 78.7%, respectively). In conclusion, TXI can improve gastrointestinal lesion detection and qualitative diagnosis. Therefore, further studies on the efficacy of TXI in clinical practice are required.

Keywords: Endoscopy, Texture and color enhancement imaging, White-light imaging, Narrow-band imaging, Colorectal neoplasm, Gastric cancer, Adenoma, Ulcerative colitis, Helicobacter infections, Colonoscopy

Core Tip: Olympus Corporation has developed texture and color enhancement imaging (TXI) as a novel image-enhancing endoscopy technique. This highlights a series of hot-topic articles investigating the usefulness of TXI for gastrointestinal disease diagnosis in clinical practice. TXI showed improvement compared with white-light imaging (WLI) and non-inferiority compared with narrow-band imaging in detecting colorectal neoplasia. TXI observation can predict the relapse of ulcerative colitis. TXI improved gastric cancer detection and diagnostic accuracy for active Helicobacter pylori gastritis compared to WLI. In conclusion, TXI can improve detection and qualitative diagnosis.