Surveillance in Ulcerative Colitis

Freire, Paulo; Figueiredo, Pedro; Cardoso, Rita; Donato, Maria Manuel; Ferreira, Manuela; Mendes, Sofia; Silva, Mário R.; Cipriano, Augusta; Ferreira, Ana; Vasconcelos, M. Helena; Portela, Francisco; Sofia, Carlos

doi:10.1097/mib.0000000000000176

Cited by 33 publications

(24 citation statements)

References 50 publications

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“…Overall, our data confirms that CE has a higher sensitivity for neoplastic lesions compared with WLE. We have to acknowledge that our results are discordant to findings from other recent studies showing no superiority of CE over WLE [ 20 , 34 , 35 ]. However, these studies excluded patients at high-risk for neoplasia such as those with coexistent PSC which, again, may have biased the results.…”

Section: Discussioncontrasting

confidence: 64%

Advanced neoplasia detection using chromoendoscopy and white light colonoscopy for surveillance in patients with inflammatory bowel disease

Kim

Chiorean

2020

Intest Res

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Background/Aims: Chromoendoscopy (CE) has been shown to be superior to white light endoscopy (WLE) for neoplasia detection in inflammatory bowel disease (IBD). We aimed to compare the yield of CE and WLE for the detection of overall neoplasia and advanced neoplasia in IBD. Methods: Patients who underwent surveillance colonoscopy from 1999 to 2017 were identified from our IBD database. CE procedures were compared with their respective WLE controls in a paired comparison, and frequency of all neoplasia, advanced neoplasia, and serrated neoplasia was assessed for both targeted and random biopsies.Results: A total of 290 procedures performed in 98 individuals were identified with a median follow-up 4 years (median 3 colonoscopies/patient). CE and WLE were performed in 159 and 131 episodes, respectively. CE detected neoplasia in 40.9% of colonoscopies versus 23.7% with WLE (P= 0.002). In addition, CE detected more advanced neoplasia (18.2% vs. 6.1%, P= 0.002) and serrated lesions (14.5% vs. 6.1%, P= 0.022). Significantly fewer samples were obtained per procedure with CE (14.9 ± 9.7 vs. 20.9 ± 11.1, P< 0.001). Cancer was diagnosed in 2 cases.Conclusions: CE has a higher detection rate than WLE for advanced neoplasia and serrated lesions in patients with IBD under surveillance. Further prospective studies evaluating the impact of CE on decreasing the risk of interval cancer and colectomy in IBD patients are warranted.

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Section: Discussioncontrasting

confidence: 64%

Advanced neoplasia detection using chromoendoscopy and white light colonoscopy for surveillance in patients with inflammatory bowel disease

Kim

Chiorean

2020

Intest Res

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“…A similar randomized trial with methylene blue CE-guided eCLE versus WLE with random biopsies in neoplasia detection in 162 UC patients with high neoplastic risk (as IN, intraepithelial neoplasia history, or PSC) revealed no significant difference in the detection for IN (8 versus 7 patients) [ 73 ], although the targeted approach did reduce biopsy sampling, in line with Kiesslich et al's study [ 71 ].…”

Section: Advanced Endoscopic Imaging Techniquessupporting

confidence: 55%

Modern Endoscopic Imaging in Diagnosis and Surveillance of Inflammatory Bowel Disease Patients

Hundorfean

Pereira

Karstensen

et al. 2018

Gastroenterology Research and Practice

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Endoscopy remains the most important diagnostic and monitoring modality in the management of inflammatory bowel disease. Advances in imaging have progressively added new tools into the armamentarium of endoscopists with the goal of more accurate, sensitive, and accessible visual diagnoses for the benefit of patients with gastrointestinal diseases. Here, we review the relevant literature regarding commonly used endoscopic techniques (dye-based and digital chromoendoscopy, high-definition endoscopy, capsule endoscopy, and endosonography), as well as advanced and experimental technologies (full-spectrum endoscopy, endocytoscopy, autofluorescence, laser endoscopy, and endomicroscopy, including molecular imaging), applicable to inflammatory bowel diseases and emerging for implementation into everyday practice. Additionally, we discuss future directions and techniques as candidates for a superior inflammation imaging in the diagnosis and prediction of therapeutic response.

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“…Three eCLE series in IBD which used Mainz classification reported sufficient data on the characterization of 306 lesions (28 neoplastic), 18,22,30 with pooled SE 93%, SP 98%, PPV 84%, NPV 99%, and ACC 98%.…”

Section: Resultsmentioning

confidence: 99%

“…In IBD, 21 studies used the Paris classification to describe the macroscopic appearance of lesions. 6,7,15,19,20,22,23,25,28,30,33–42,44 Pooling data from six studies which clearly described the prevalence of each Paris class among 2619 lesions, 6,28,34,38,44,45 the most frequent morphology was Is (40.5%), followed by IIa (29.6%), IIb (21%), Ip (8%), IIc (0.6%), and Isp (0.3%). Slightly elevated (IIa) lesions were however the most frequent morphology (59%) in a series of 74 exclusively neoplastic lesions from two studies, followed by Is (23%), IIb (12%), and Ip and IIc (3%).…”

Section: Resultsmentioning

confidence: 99%

Endoscopic characterization of neoplastic and non-neoplastic lesions in inflammatory bowel disease: systematic review in the era of advanced endoscopic imaging

Cassinotti,

Parravicini,

Chapman

et al. 2023

Therap Adv Gastroenterol

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Background: Current guidelines strongly recommend the use of validated classifications to support optical diagnosis of lesions with advanced endoscopic imaging in the lower gastrointestinal tract. However, the optimal strategy in inflammatory bowel disease (IBD) is still a matter of debate. Objectives: To analyze the accuracy of endoscopic classifications or single predictors for in vivo lesion characterization during endoscopic surveillance of IBD with advanced endoscopic imaging. Design: Systematic review. Data sources and methods: Medline and PubMed were used to extract all studies which focused on lesion characterization of neoplastic and non-neoplastic lesions in IBD. The diagnostic accuracy of endoscopic classifications and single endoscopic predictors for lesion characterization were analyzed according to type of patients, lesions, and technology used. When available, the rates of true and false positives or negatives for neoplasia were pooled and the sensitivity (SE), specificity (SP), positive predictive value, and negative predictive value (NPV) were calculated. Results: We included 35 studies (2789 patients; 5925 lesions – 1149 neoplastic). Advanced endoscopic imaging included dye-based chromoendoscopy, virtual chromoendoscopy (VCE), magnification and high-definition endoscopy, confocal laser endomicroscopy (CLE), endocytoscopy, and autofluorescence imaging. The Kudo classification of pit patterns was most frequently used, with pooled SE 83%, SP 83%, and NPV 95%. The endoscopic criteria with the highest accuracy, with minimum SE ⩾ 90%, SP ⩾ 80%, and NPV ⩾ 90% were: the Kudo-IBD classification used with VCE (Fuji Intelligent Color Enhancement and i-SCAN); combined irregular surface and vascular patterns used with narrow band imaging; the Mainz classification used with CLE. Multiple clinical and technical factors were found to influence the accuracy of optical diagnosis in IBD. Conclusion: No single endoscopic factor has yet shown sufficient accuracy for lesion characterization in IBD surveillance. Conventional classifications developed in the non-IBD setting have lower accuracy in IBD. The use of new classifications adapted for IBD (Kudo-IBD), and new technologies based on in vivo microscopic analysis show promise.

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Surveillance in Ulcerative Colitis

Cited by 33 publications

References 50 publications

Advanced neoplasia detection using chromoendoscopy and white light colonoscopy for surveillance in patients with inflammatory bowel disease

Advanced neoplasia detection using chromoendoscopy and white light colonoscopy for surveillance in patients with inflammatory bowel disease

Modern Endoscopic Imaging in Diagnosis and Surveillance of Inflammatory Bowel Disease Patients

Endoscopic characterization of neoplastic and non-neoplastic lesions in inflammatory bowel disease: systematic review in the era of advanced endoscopic imaging

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