Utility Of Chromoendoscopy Research Articles

Multicentre randomised controlled trial on virtual chromoendoscopy in the detection of neoplasia during colitis surveillance high-definition colonoscopy (the VIRTUOSO trial)

BackgroundLongstanding colonic IBD increases the risk of developing colorectal cancer. The utility of chromoendoscopy with standard-definition white light technology has been established. However, the use of high-definition virtual chromoendoscopy (HDV)...

P397 Surveillance in ulcerative colitis: Can we predict the risk for intraepithelial neoplasia?

Abstract Background Ulcerative colitis (UC) has been associated with an increased risk of colorectal cancer (CRC). Although dye spray chromoendoscopy showed superiority to standard colonoscopy in surveillance studies, with the availability of higher-resolution colonoscopes, the utility of chromoendoscopy (CE) has been questioned. We aimed to evaluate the risk of intraepithelial neoplasia (IN) after a high-quality screening colonoscopy (making use of CE or random biopsies (RB) and removing all detected lesions) in a population with longstanding UC and to identify potential risk factors for dysplasia incidence. Methods In a previous study, 145 patients with clinically and endoscopic longstanding (≥8 yr) distal/extensive UC without primary sclerosing cholangitis and/or history of IN were prospectively randomised to undergo CE or RB. In this study, after a median follow-up of 5 additional years, we evaluated subsequent IN incidence in these patients, submitted to surveillance colonoscopy. Patients without high-quality surveillance colonoscopy (with good bowel preparation and cecum intubation) using high-definition were excluded. Results One hundred and twenty-one patients were included. Nine had removed adenomas with low-grade dysplasia in the index colonoscopy. Now, in surveillance colonoscopy, we detected 9 (7.4%) IN: low-grade dysplasia was found in 8 (6.6%) patients and a colorectal adenocarcinoma in 1 (0.008%) patient. After multivariate analysis, IN was significantly associated with older age (68 vs. 52 years, p < 0.05) and higher disease duration (26 vs. 20 years, p < 0.05). No association was found between IN and previous detection of IN in screening colonoscopy sex, the CE or RB use in index colonoscopy, extent of disease, The presence of pseudopolyps, smoking habits, familial history of CRC or maintenance therapy for UC. Conclusion In this study, older patients and higher disease duration were associated with a higher risk of IN in surveillance colonoscopy.

PTU-009 The utility of routine chromoendoscopy for detection of dysplastic lesions during surveillance colonoscopy in patients with colonic inflammatory bowel disease. does research translate to clinical practice?

Introduction Dysplasia in colonic inflammatory bowel disease (IBD) is often multifocal and flat. Chromoendoscopy (CE) has been shown in prospective studies to improve dysplasia detection rates by improving the ability to detect subtle mucosal changes. 1 The utility of CE in dysplasia detection in patients with IBD during routine clinical practice has not been reported so far. We aimed to compare the yield of dysplastic lesions detected by CE with standard white light endoscopy (WLE). Method Retrospective cohort study of patients with long standing (>7 years) colonic IBD undergoing surveillance colonoscopy at Leeds Teaching Hospital NHS Trust between January 2012 to December 2013. Details of diagnosis, duration of disease and outcomes of the colonoscopy were collected from the endoscopy database, electronic patient records and patient notes. Results There were 120 colonoscopies in the CE group and 220 colonoscopies in the WLE group. The groups were well matched for all demographic variables. 27 dysplastic lesions were detected in 20 patients in the CE group and 9 dysplastic lesions were detected in 6 patients in the WLE group. All the lesions were detected on targeted biopsy and harboured low grade dysplasia. The adjusted prevalence ratio (on a per patient basis) for detecting any dysplastic lesion was 4.6 (95% CI 1.6–13.7) in favour of CE. Conclusion CE colonoscopy improves detection of dysplastic lesions during surveillance colonoscopy of patients with colonic IBD even in routine clinical practice, confirming data from prospective trials. CE should be the standard of care for all IBD surveillance procedures as advocated by both BSG and ECCO guidelines. Disclosure of interest None Declared. Reference Subramanian V, Mannath J, Ragunath K, et al . Meta-analysis: the diagnostic yield of chromoendoscopy for detecting dysplasia in patients with colonic inflammatory bowel disease. Aliment Pharmacol Ther. 2011;33(3):304–12

P-155 YI Utility of Chromoendoscopy Assisted Small Bowel Capsule Endoscopy in the Calculation of Lewis Score

P-155 YI Utility of Chromoendoscopy Assisted Small Bowel Capsule Endoscopy in the Calculation of Lewis Score

Chromoendoscopy

Chromoendoscopy involves the use of stains or dyes during endoscopy to improve the visualization and characterization of the gastrointestinal mucosa. Its main clinical application is the detection of dysplasia or early cancer of the gastrointestinal tract in individuals with pre-malignant conditions or hereditary and environmental factors that predispose them to cancer. The utility of chromoendoscopy has been mostly studied in squamous cell carcinoma of the esophagus, Barrett's esophagus, gastric cancer, colorectal polyps, and chronic ulcerative colitis. Although chromoendoscopy has been shown to be feasible and safe, several limitations have prevented its widespread use in endoscopy. Despite this, chromoendoscopy remains a useful adjunct to standard white light endoscopy in the visualization of mucosal lesions, which may potentially improve tissue diagnosis and impact patient care.

Utility of Chromoendoscopy with Lugol Solution Spraying in Early Detection of Esophageal Squamous Cell Carcinoma and Dysplasia

Utility of Chromoendoscopy with Lugol Solution Spraying in Early Detection of Esophageal Squamous Cell Carcinoma and Dysplasia