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

Gut
Kesavan KandiahPradeep Bhandari

Abstract

Longstanding 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) in colitis surveillance remains undefined. To compare the performance of HDV (i-scan OE mode 2) with high-definition white light (HDWL) for detection of neoplasia in patients with IBD undergoing surveillance colonoscopy. Additionally, we assessed the utility of protocol-guided quadrantic non-targeted biopsies. A multioperator randomised controlled trial was carried out in two centres in the UK. Total of 188 patients (101 men, mean age 54) with longstanding ulcerative or Crohn's colitis were randomised, prior to starting the surveillance colonoscopy, to using either HDV (n=94) or HDWL (n=94) on withdrawal. Targeted and quadrantic non-targeted biopsies were taken in both arms per-randomisation protocol. The primary outcome was the difference in neoplasia detection rate (NDR) between HDV and HDWL. There was no significant difference between HDWL and HDV for neoplasia detection. The NDR was not significantly different for HDWL (24.2%) and HDV (14.9%) (p=0.14). All intraepithelial neoplasia (I...Continue Reading

References

May 1, 1994·Gut·C D GillenR N Allan
Oct 11, 2008·The American Journal of Gastroenterology·James F MarionUNKNOWN Chromoendoscopy Study Group at Mount Sinai School of Medicine
Apr 30, 2010·Gut·Stuart R CairnsUNKNOWN Association of Coloproctology for Great Britain and Ireland
May 23, 2012·The American Journal of Gastroenterology·Ana IgnjatovicBrian P Saunders
Feb 24, 2015·Gastroenterology·Loren LaineUNKNOWN SCENIC Guideline Development Panel
Jan 26, 2016·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Miriam F GasiaMarietta Iacucci
Aug 24, 2018·Journal of Crohn's & Colitis·Christian MaaserUNKNOWN European Crohn’s and Colitis Organisation [ECCO] and the European Society of Gastrointestinal and Abdominal Radiology [ESGAR
Sep 11, 2019·Alimentary Pharmacology & Therapeutics·Andrea IannoneGiovanni F M Strippoli
Nov 8, 2019·The Lancet. Gastroenterology & Hepatology·Marietta IacucciSubrata Ghosh

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