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CC BY 4.0 · Endosc Int Open 2025; 13: a27606529
DOI: 10.1055/a-2760-6529
Original article

Comparison of adenoma detection rate using the novel 5-LED vs xenon-light endoscopic system: Propensity score matching analysis

Authors

  • Tatsuhiro Ito

    1   First Department of Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan (Ringgold ID: RIN12793)

  • Satoshi Osawa 

    2   Department of Advanced Medical Science for Regional Collaboration, Hamamatsu University School of Medicine, Hamamatsu, Japan (Ringgold ID: RIN12793)
    3   Department of Endoscopic and Photodynamic Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan (Ringgold ID: RIN12793)

  • Takanori Yamada

    3   Department of Endoscopic and Photodynamic Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan (Ringgold ID: RIN12793)

  • Keisuke Inagaki

    1   First Department of Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan (Ringgold ID: RIN12793)

  • Tomohiro Takebe

    1   First Department of Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan (Ringgold ID: RIN12793)

  • Satoru Takahashi

    1   First Department of Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan (Ringgold ID: RIN12793)

  • Shunya Onoue

    1   First Department of Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan (Ringgold ID: RIN12793)

  • Kiichi Sugiura

    4   First Department of Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan

  • Natsuki Ishida

    1   First Department of Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan (Ringgold ID: RIN12793)

  • Tomoharu Matsuura

    5   Department of Laboratory Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan (Ringgold ID: RIN12793)

  • Mihoko Yamade

    1   First Department of Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan (Ringgold ID: RIN12793)

  • Moriya Iwaizumi

    5   Department of Laboratory Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan (Ringgold ID: RIN12793)

  • Yasushi Hamaya

    1   First Department of Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan (Ringgold ID: RIN12793)

  • Ken Sugimoto

    1   First Department of Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan (Ringgold ID: RIN12793)
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Abstract

Background and study aims

Olympus’s new endoscopic system, EVIS X1, features five-LED illumination and a novel complementary metal-oxide-semiconductor (CMOS) image sensor distinct from conventional charge-coupled devices (CCDs), potentially improving colorectal adenoma detection rates (ADRs). This study compared ADR and related indicators between the EVIS X1 system and the conventional EVIS LUCERA ELITE, a xenon-light system.

Patients and methods

Of 4,915 colonoscopies performed between September 2020 and April 2023, 814 EVIS X1 and 953 LUCERA cases met inclusion criteria. After propensity score matching to balance baseline characteristics, 660 patients per group were analyzed. Outcomes included ADR, polyp detection rate (PDR), adenomas per colonoscopy (APC), and polyps per colonoscopy (PPC). Subgroup analysis assessed the impact of CMOS-equipped scopes within the X1 group.

Results

ADR was slightly higher in the X1 group (36.1%) than the LUCERA group (32.1%), although not statistically significant (P = 0.147). APC (0.77 vs. 0.61, P = 0.034) and PPC (0.95 vs. 0.75, P = 0.023) were significantly higher with X1. Within the X1 group, scopes with CMOS sensors achieved a significantly higher ADR (41.9%) compared with those without. Mean size of polyps detected was smaller with CMOS than with CCD scopes. Multivariate analysis identified age > 60 years, male sex, positive fecal occult blood test, and use of the X1 system with CMOS scopes as independent predictors of higher ADR.

Conclusions

The EVIS X1 system may have the potential to improve adenoma detection, particularly when used with CMOS sensor-equipped scopes. These findings suggest potential benefits for colorectal cancer screening, although further large-scale studies are warranted for validation.

Keywords

Endoscopy Lower GI Tract - Polyps / adenomas / ... - Diagnosis and imaging (inc chromoendoscopy, NBI, iSCAN, FICE, CLE...) - Endoscopic resection (polypectomy, ESD, EMR, ...)

Supplementary Material



Publication History

Received: 07 May 2025

Accepted after revision: 12 November 2025

Accepted Manuscript online:
01 December 2025

Article published online:
19 December 2025

© 2026. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/).

Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

Bibliographical Record
Tatsuhiro Ito, Satoshi Osawa, Takanori Yamada, Keisuke Inagaki, Tomohiro Takebe, Satoru Takahashi, Shunya Onoue, Kiichi Sugiura, Natsuki Ishida, Tomoharu Matsuura, Mihoko Yamade, Moriya Iwaizumi, Yasushi Hamaya, Ken Sugimoto. Comparison of adenoma detection rate using the novel 5-LED vs xenon-light endoscopic system: Propensity score matching analysis. Endosc Int Open 2025; 13: a27606529.
DOI: 10.1055/a-2760-6529
 

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