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This study used an eye-tracking system to compare white-light imaging (WLI), narrow-band imaging (NBI), and texture and color enhancement imaging (TXI) mode-1 and mode-2. Twelve endoscopists assessed 120 images from 30 lesions, recording gaze movements to measure lesion miss rate and detection time from image display to first gaze. 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Eye movements were recorded to analyze the lesion detection ability and time taken. The miss rate (calculated as the ratio of missed lesions from 360 images) and detection time (defined as the time from displaying the image to the start of gaze on lesions) were compared among the four modalities.  \nResults: The miss rates ofWLI, NBI, TXI mode-1, and TXI mode-2 were 16.4%, 6.4%, 11.7%, and 16.7%, respectively. The miss rate of NBI was significantly lower than those of WLI and TXI mode-2 (p \u003C 0.001) . The detection times (median [interquartile range]) of WLI, NBI, TXI mode-1, and TXI mode-2 were 0.71 (0.43–1.37) s, 0.54 (0.34–0.89) s, 0.63 (0.44–1.13) s, and 0.64 (0.37–1.28) s, respectively. NBI had the shortest detection time among the four modalities (p \u003C 0.001 compared with WLI and TXI mode-2; p = 0.005 compared with TXI mode-1) .  \nConclusions: Objective assessment using the eye tracking system revealed that NBI provided the best colorectal lesion visibility, with the lowest miss rate and shortest detection time.  \n1 | Introduction  \nMortality from colorectal cancer (CRC) remains high, underscoring the importance of early detection and resection of colorectal lesions to prevent CRC. The adenoma detection rate (ADR) is a crucial quality measure in colonoscopy, with improved ADR leading to reduced CRC incidence and mortality [1–3] . Colonoscopy is a reliable method for the early detection and removal of adenomas and early-stage cancers; however,  \nthe miss rate for adenomatous polyps with white-light imaging (WLI) is high at 20%–26%[4, 5] .  \nImage-enhanced endoscopy (IEE) technologies such as narrowband imaging (NBI; Olympus Medical Co., Tokyo, Japan) and blue-laser imaging (BLI; Fujifilm Co., Tokyo, Japan) have been developed to improve colorectal lesion detection. Additionally, in 2020, a new endoscopic system, the EVIS X1 with third-generation NBI and texture and color enhancement  \nThis is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.  \n© 2025 The Author(s). Journal of Gastroenterology and Hepatology published by Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.  \n278 Journal of Gastroenterology and Hepatology, 2026; 41:278–285  \n[https://doi.org/10.1111/jgh.70191](https://doi.org/10.1111/jgh.70191) ","cbCaidQIOyuwxI2z","https://ap.wps.com/l/cbCaidQIOyuwxI2z","pdf",1347698,"English","# Abstract\n## Background and Aim\n## Methods\n## Results\n## Conclusions\n# Introduction","[{\"question\":\"What was the study objective regarding colorectal lesions?\",\"answer\":\"To objectively evaluate colorectal lesion visibility using WLI, NBI, and TXI with an eye tracking system.\"},{\"question\":\"How were detection time and miss rate measured?\",\"answer\":\"Detection time was defined as the interval from displaying an image to the start of gaze on lesions, and miss rate was calculated from missed lesions across the assessed images.\"},{\"question\":\"Which imaging modality performed best for lesion visibility?\",\"answer\":\"NBI provided the best visibility, with the lowest miss rate and shortest detection time compared with the other modalities.\"}]","Objective Assessment of Visibility of Colorectal Lesions Using Eye Tracking for New Image-Enhanced Endoscopy Observation | PDF",1790756113]