| Narrow band imaging for detection of dysplasia in colitis: a randomized controlled trial. | |
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MedLine Citation:
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PMID: 22613903 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: The American journal of gastroenterology Volume: 107 ISSN: 1572-0241 ISO Abbreviation: Am. J. Gastroenterol. Publication Date: 2012 Jun |
Date Detail:
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Created Date: 2012-07-27 Completed Date: 2012-09-06 Revised Date: 2013-05-07 |
Medline Journal Info:
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Nlm Unique ID: 0421030 Medline TA: Am J Gastroenterol Country: United States |
Other Details:
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Languages: eng Pagination: 885-90 Citation Subset: IM |
Affiliation:
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Wolfson Unit for Endoscopy, St Mark's Hospital, Harrow, UK. anaignjatovic@me.com |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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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:
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0/Coloring Agents |
| Comments/Corrections | |
Comment In:
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Endoscopy. 2013;45(4):289-91
[PMID:
23468192
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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