Evaluation of Visibility With an Eye‐tracking System: Effectiveness of Narrow‐Band Imaging for Detecting Colorectal Adenoma and Serrated Lesions

ABSTRACT Objectives Image‐enhanced endoscopy may reduce colorectal cancer mortality by improving lesion detection. Narrow‐band imaging and texture and color enhancement imaging are widely used, but their diagnostic efficacy compared with white light imaging remains unclear. This study evaluated narrow‐band imaging and texture and color enhancement imaging versus white light imaging for detecting colorectal lesions, including adenomas and serrated lesions. Methods Images of 29 colorectal lesions (19 adenomas and 10 serrated lesions) measuring 10 mm or less were captured using white light imaging, narrow‐band imaging, and texture and color enhancement imaging mode 1. Twelve endoscopists (six experts and six non‐experts) identified lesions in randomly presented images while eye movements were recorded. Detection rates and times were analyzed. Results Detection rates for adenomas and serrated lesions did not differ significantly among white light imaging, narrow‐band imaging, and texture and color enhancement imaging in either group. However, detection time varied significantly. Among experts, adenomas were detected faster with narrow‐band imaging than with white light imaging and texture and color enhancement imaging; serrated lesions were detected faster with narrow‐band imaging than with texture and color enhancement imaging. Among non‐experts, narrow‐band imaging also shortened detection time compared with white light imaging for both lesion types. Conclusions Narrow‐band imaging enables quicker detection of adenomas and serrated lesions than white light imaging and texture and color enhancement imaging for both experts and non‐experts.