Document Detail


Narrow band imaging for detection of dysplasia in colitis: a randomized controlled trial.
MedLine Citation:
PMID:  22613903     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: In ulcerative colitis surveillance, chromoendoscopy improves dysplasia detection 3 – 5-fold compared with white light endoscopy (WLE). The aim of this study was to investigate whether narrow band imaging (NBI) can improve dysplasia detection compared with WLE.
METHODS: This was a randomized, parallel-group trial. A total of 220 patients were needed to be recruited to detect a threefold increase in dysplasia detection. In all, 112 patients with long-standing ulcerative colitis were randomized to colonoscopic extubation with NBI (56) or WLE (56) (1:1 ratio) at two tertiary endoscopy units in the United Kingdom. Targeted biopsies of suspicious areas and quadrantic random biopsies every 10 cm were taken in both groups. The primary outcome measure was the proportion of patients with at least one area of dysplasia detected. In a prespecified mid-point analysis, the criteria for trial discontinuation were met and the trial was stopped and analyzed at this point.
RESULTS: There was no difference in the primary outcome between the two groups, with 5 patients having at least one dysplastic lesion in each group (odds ratio (OR) 1.00, 95 % confidence interval (95 % CI) 0.27 – 3.67, P = 1.00). This remained unchanged when adjusted for other variables (OR 0.69, 95 % CI 0.16 – 2.96, P = 0.62). Overall, dysplasia detection was 9 % in each arm. Yield of dysplasia from random nontargeted biopsies was 1 / 2,707 (0.04 % ).
CONCLUSIONS: Overall, in this multicenter parallel-group trial, there was no difference in dysplasia detection when using NBI compared with high-definition WLE colonoscopy. Random background biopsies were ineffective in detecting dysplasia.
Authors:
Ana Ignjatovic; James E East; Venkat Subramanian; Noriko Suzuki; Thomas Guenther; Nicky Palmer; Paul Bassett; Krish Ragunath; Brian P Saunders
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Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The American journal of gastroenterology     Volume:  107     ISSN:  1572-0241     ISO Abbreviation:  Am. J. Gastroenterol.     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-07-27     Completed Date:  2012-09-06     Revised Date:  2013-05-07    
Medline Journal Info:
Nlm Unique ID:  0421030     Medline TA:  Am J Gastroenterol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  885-90     Citation Subset:  IM    
Affiliation:
Wolfson Unit for Endoscopy, St Mark's Hospital, Harrow, UK. anaignjatovic@me.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Biopsy
Colitis, Ulcerative / pathology*
Colonoscopy / methods*
Coloring Agents / diagnostic use
False Positive Reactions
Female
Great Britain
Humans
Male
Middle Aged
Odds Ratio
Population Surveillance* / methods
Prospective Studies
Chemical
Reg. No./Substance:
0/Coloring Agents
Comments/Corrections
Comment In:
Endoscopy. 2013;45(4):289-91   [PMID:  23468192 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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