ReviewDigestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society2026
Comparative Performance of Image-Enhanced Endoscopy for Adenoma and Sessile Serrated Lesion Detection: A Network Meta-Analysis.
Review in Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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3 authors.
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Abstract
BACKGROUND AND
aimsImage-enhanced endoscopy (IEE) technologies have been developed to improve colorectal polyp detection, but their comparative efficacy remains uncertain. We performed a network meta-analysis to compare the efficacy of major IEE modalities on colorectal polyp detection.
methodsWe searched MEDLINE, Embase, and CENTRAL for randomized controlled trials comparing seven IEE modalities (autofluorescence imaging, blue-light imaging, flexible spectral imaging color enhancement, i-scan, linked color imaging [LCI], narrow band imaging [NBI], and texture and color enhancement imaging [TXI]) with white-light imaging (WLI). The primary outcome was the comparison of performance of IEE systems in adenoma detection rate (ADR); the secondary outcome was sessile serrated lesion detection rate (SSLDR). We estimated the number needed to screen (NNS) with 95% credible intervals (CrIs). Study credibility was assessed using the Confidence in Network Meta-analysis (CINeMA) framework.
resultsFifty-three randomized controlled trials encompassing 34,364 patients were included. Compared with WLI, moderate-confidence evidence supported improvements in ADR with TXI (NNS 13, 95% CrIs 7-32), LCI (NNS 17, 95% CrIs 11-31), and NBI (NNS 35, 95% CrIs 18-139), whereas low-confidence evidence supported benefits for i-scan (NNS 7, 95% CrIs 3-18). Direct comparison across IEEs demonstrated little-to-no clinically meaningful differences in ADR. For SSLDR, moderate-confidence evidence supported improvements with LCI (NNS 29, 95% CrIs 15-96) and NBI (NNS 38, 95% CrIs 19-143) compared with WLI.
conclusionsLCI demonstrated the most robust and reproducible performance across multiple analyses with moderate-confidence evidence, although differences among IEE modalities were generally modest.
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