Virtual Chromoendoscopy Easier, Faster, More Comfortable for Patients
Virtual chromoendoscopy appeared to be as good as traditional chromoendoscopy at diagnosing dysplastic lesions while being quicker, easier and more comfortable for patients, according to research published in Inflammatory Bowel Diseases.
Shraddha Gulati, MBBS, MRCP, of the King’s Institute of Therapeutic Endoscopy at King’s College Hospital in the United Kingdom, and colleagues wrote that future studies could potentially confirm the theory that virtual chromoendoscopy (CE) might overcome some of the challenges that have prevented the wider adoption of dye-based CE and could prove beneficial for colitis surveillance.
“In noncolitis studies, Fujinon Intelligent [Color] Enhancement (FICE) has been shown to be comparable to CE for adenoma detection, superior to [white light endoscopy] for the endoscopic diagnosis of adenomas even without magnification, and comparable to CE, including the differentiation of dysplasia in diminutive lesions, with a trend favoring FICE in adenomas,” Gulati and colleagues wrote “However, there are no studies to date evaluating FICE in colitis surveillance.”
Researchers randomly assigned 48 patients to undergo either virtual CE (n = 23) or traditional CE (n = 25), and after 3 to 8 weeks, they underwent screening with the other method. Investigators recorded missed dysplasia, prediction of dysplasia and assessed patient experience using validated questionnaires and pain scores.
Gulati and colleagues found that virtual CE missed one lesion while traditional CE missed two lesions. Dysplasia diagnostic accuracy was 93.4% in virtual CE compared with 76.9% in dye-based CE. Virtual CE also had lower examination time (14 +/– 4 minutes vs. 20 +/– 7 minutes; 95% CI, 3.5–8) and pain scores based on a visual analog scale (27.4 +/– 17.5 vs. 34.7 +/– 18) compared with traditional CE. It was also preferred by more patients (67% vs. 33%; P < .001). Although researcher did not specifically explore reasons for patient preference in the trial, the suggested that it might be due to the shorter procedure time, the absence of a contrast agent and less bloating or cramping.
Gulati and colleagues wrote that their findings form as base to build future research that could ultimately help improve adherence and success of surveillance.
“[Virtual] CE is free from the limiting aspects of CE, is a shorter procedure with dysplasia detection as effective as that of CE, and is the preferred modality by patients,” they wrote. “This trial forms the successful foundation for a planned future multicenter trial that will produce robust data for colitis surveillance.” - by Alex Young
Disclosures: Healio Gastroenterology and Liver Disease could not confirm the authors’ relevant financial disclosures prior to publication.