Endoscopic tri-modal imaging for surveillance in ulcerative colitis: randomised comparison of high-resolution endoscopy and autofluorescence imaging for neoplasia detection; and evaluation of narrow-band imaging for classification of lesions
2008

Endoscopic Imaging Techniques for Neoplasia Detection in Ulcerative Colitis

Sample size: 50 publication Evidence: moderate

Author Information

Author(s): van den Broek F J C, Fockens P, van Eeden S, Reitsma J B, Hardwick J C H, Stokkers P C F, Dekker E

Primary Institution: Academic Medical Centre Amsterdam

Hypothesis

To assess the value of endoscopic tri-modal imaging (ETMI) for the detection and classification of neoplasia in patients with longstanding ulcerative colitis.

Conclusion

Autofluorescence imaging improves the detection of neoplasia in patients with ulcerative colitis and decreases the yield of random biopsies.

Supporting Evidence

  • AFI detected 10 neoplastic lesions with no additional neoplasia found by WLE.
  • WLE missed 50% of neoplastic lesions compared to 0% for AFI.
  • Random biopsies revealed neoplasia in only 0.1% of cases.

Takeaway

Doctors used special cameras to look for cancer in patients with a bowel disease, and they found that one type of camera was much better at spotting problems than the other.

Methodology

Fifty patients with ulcerative colitis underwent surveillance colonoscopy with endoscopic tri-modal imaging, inspecting each colonic segment twice with autofluorescence imaging and white light endoscopy in random order.

Potential Biases

Potential selection bias due to the tertiary referral nature of the institution.

Limitations

The study had a relatively small sample size and was conducted in a single expert center.

Participant Demographics

Patients with inactive pan-ulcerative colitis scheduled for surveillance colonoscopy, mean age 50 years, 68% male.

Statistical Information

P-Value

0.036

Confidence Interval

95% CI, 51 to 90

Statistical Significance

p=0.036

Digital Object Identifier (DOI)

10.1136/gut.2007.144097

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