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Related Experiment Video

Updated: Sep 13, 2025

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An Additional 30-s Observation of the Right-Sided Colon Using a Novel Endoscopic System with Texture and Color

Yoshikazu Inagaki1, Naohisa Yoshida2, Hikaru Hashimoto3

  • 1Department of Gastroenterology, Nishijin Hospital, Kyoto 6028319, Japan.

Diagnostics (Basel, Switzerland)
|July 29, 2025
PubMed
Summary

An additional 30-second observation using enhanced imaging (TXI) significantly improved adenoma and sessile serrated lesion detection rates during colonoscopy. This novel system enhances polyp detection in the right-sided colon, addressing a common challenge in colorectal cancer screening.

Keywords:
ADRTXIcolonoscopypolyp missright-sided colon

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Area of Science:

  • Gastroenterology
  • Endoscopic imaging technologies
  • Colorectal cancer screening

Background:

  • White light imaging (WLI) in colonoscopy has a significant adenoma miss rate of 26%.
  • The right-sided colon is particularly prone to missed lesions during endoscopic examination.
  • Novel imaging systems aim to improve adenoma detection rates (ADR) and sessile serrated lesion detection rates (ASDR).

Purpose of the Study:

  • To evaluate the effectiveness of an additional 30-second (Add-30s) observation of the right-sided colon.
  • To assess the utility of a novel system with texture and color enhancement imaging (TXI) in improving lesion detection.
  • To compare the performance of the novel system against previous colonoscopy imaging technologies.

Main Methods:

  • A retrospective review of 515 patients undergoing colonoscopy with Add-30s TXI between February 2021 and December 2023.
  • Colonoscopies involved initial WLI followed by re-observation of the right-sided colon using Add-30s TXI.
  • Propensity score matching (PSM) was used to compare the novel system with previous scopes for WLI and TXI efficacy.

Main Results:

  • Add-30s TXI observation increased right-sided ADR by 7.4% and ASDR by 9.5%.
  • The novel scope was an independent factor for adenoma and SSL detection (odds ratio: 2.41, p < 0.01).
  • Right-sided ADR and ASDR were significantly higher with the novel scope using Add-30s TXI compared to the previous scope (ADR: 25.2% vs. 15.3%; ASDR: 32.4% vs. 18.9%).

Conclusions:

  • The Add-30s TXI observation significantly enhances the detection of adenomas and sessile serrated lesions in the right-sided colon.
  • The novel endoscopic system demonstrates superior performance in detecting colorectal lesions compared to previous technologies.
  • Implementing enhanced imaging techniques and extended observation times can improve the miss rates in colonoscopy.