The addition of computer aided detection to texture and colour enhancement imaging (TXI) for adenoma detection during colonoscopy: have we reached a glass ceiling?

The use of texture and colour enhancement imaging (TXI) - a form of advanced endoscopic imaging technology, in combination with artificial intelligence for the detection of colonic polyps. TXI is a 'push-button' technology included with Olympus endoscopy systems which will be set in use for the entire colonoscope withdrawal. Artificial intelligence (computer aided detection) is an additional system that can be added to the Olympus endoscopy system, which uses artificial intelligence to identify and highlight colonic polyps. The anticipated time of colonoscopy is approximately 20 minutes, with AI processing occurring in real time. The procedures will be performed by consultant gastroenterologists in both the intervention and control groups. The computer aided detection images will be incorporated into a single colonoscopy report completed by the gastroenterologist. The intervention will be delivered once at the time of colonoscopy and includes only the index colonoscopy. This will be performed at two tertiary centres in South Australia. Patients are not required to adhere to the intervention. All proceduralists are involved as associate investigators and aware of the trial protocol. The principal investigator will be providing oversight to ensure adherence.