G E Tontini1, M Vecchi, M F Neurath, H Neumann. 1. Department of Medicine I, University of Erlangen-Nuremberg, Erlangen, Germany; Gastroenterology and Digestive Endoscopy Unit, IRCCS Policlinico San Donato, San Donato Milanese, Italy.
Abstract
BACKGROUND: Recent innovations in gastrointestinal endoscopy have changed our traditional approach to diagnosis and therapy in patients with inflammatory bowel diseases (IBD). While traditionally used dye-based chromoendoscopy (DBC) techniques suffer from several limitations that reduce their utility in daily routine practice, newer 'dye-less' chromoendoscopy (DLC) techniques offer a great potential to overcome most of these limitations. AIM: To review available optical and digital chromoendoscopy techniques, by critically discussing their potential for diagnostic and surveillance colonoscopy in patients with IBD. METHODS: A literature search on the use of dye-less and dye-based chromoendoscopy in IBD patients was performed. RESULTS: In long-standing IBD, DBC improves detection of dysplasia (diagnostic odds ratio = 17.5, 95% CI = 1.2-247.1) as well as prediction of inflammatory disease activity and extent of disease compared with standard video-colonoscopy. Narrow band imaging (NBI) shows no improvement in dysplasia detection rates compared with white-light endoscopy and DBC (P = 0.6). Moreover, NBI results in a suboptimal differentiation of dysplastic from nondysplastic lesions. No data regarding digital DLC techniques (i.e. FICE, i-scan) for dysplasia detection in IBD are yet available. Both NBI and i-scan are superior to white-light endoscopy in assessing the activity and extent of colorectal IBD. CONCLUSIONS: Although the potential benefits of newer optical and digital dye-less chromoendoscopy techniques over traditionally used DBC are substantial, only DBC can currently be recommended to improve dysplasia detection in long-standing IBD. In contrast, DLC has the potential to quantify disease activity and mucosal healing in IBD.
BACKGROUND: Recent innovations in gastrointestinal endoscopy have changed our traditional approach to diagnosis and therapy in patients with inflammatory bowel diseases (IBD). While traditionally used dye-based chromoendoscopy (DBC) techniques suffer from several limitations that reduce their utility in daily routine practice, newer 'dye-less' chromoendoscopy (DLC) techniques offer a great potential to overcome most of these limitations. AIM: To review available optical and digital chromoendoscopy techniques, by critically discussing their potential for diagnostic and surveillance colonoscopy in patients with IBD. METHODS: A literature search on the use of dye-less and dye-based chromoendoscopy in IBD patients was performed. RESULTS: In long-standing IBD, DBC improves detection of dysplasia (diagnostic odds ratio = 17.5, 95% CI = 1.2-247.1) as well as prediction of inflammatory disease activity and extent of disease compared with standard video-colonoscopy. Narrow band imaging (NBI) shows no improvement in dysplasia detection rates compared with white-light endoscopy and DBC (P = 0.6). Moreover, NBI results in a suboptimal differentiation of dysplastic from nondysplastic lesions. No data regarding digital DLC techniques (i.e. FICE, i-scan) for dysplasia detection in IBD are yet available. Both NBI and i-scan are superior to white-light endoscopy in assessing the activity and extent of colorectal IBD. CONCLUSIONS: Although the potential benefits of newer optical and digital dye-less chromoendoscopy techniques over traditionally used DBC are substantial, only DBC can currently be recommended to improve dysplasia detection in long-standing IBD. In contrast, DLC has the potential to quantify disease activity and mucosal healing in IBD.
Authors: Gian Eugenio Tontini; Maurizio Vecchi; Luca Pastorelli; Markus F Neurath; Helmut Neumann Journal: World J Gastroenterol Date: 2015-01-07 Impact factor: 5.742
Authors: Timo Rath; Gian E Tontini; Andreas Nägel; Michael Vieth; Steffen Zopf; Claudia Günther; Arthur Hoffman; Markus F Neurath; Helmut Neumann Journal: BMC Gastroenterol Date: 2015-10-22 Impact factor: 3.067