Related Experiment Video
Updated: Jun 17, 2026
Murine Endoscopy for In Vivo Multimodal Imaging of Carcinogenesis and Assessment of Intestinal Wound Healing and Inflammation
Published on: August 26, 2014
Time-gated fluorescence spectroscopy improves endoscopic detection of low-grade dysplasia in ulcerative colitis
Maria-Anna Ortner1, Virginia Fusco, Bernd Ebert
1Department of Gastroenterology, University Hospital for Visceral Surgery and Medicine, University Hospital Inselspital, Bern, Switzerland. ma.ortner@bluewin.ch
Background:
Dysplasia in ulcerative colitis is frequently missed with 4-quadrant biopsies. An experimental setup recording delayed fluorescence spectra simultaneously with white light endoscopy was recently developed.
Objective:
We compared detection of invisible flat intraepithelial neoplasia with protoporphyrin IX fluorescence and standard 4-quadrant biopsies.
Design:
Prospective, crossover design without randomization of the order of procedures.
Setting:
Gastroenterology Department, Humboldt University, Charité, Berlin, Germany.
Patients:
Forty-two patients with extensive ulcerative colitis of more than 10 years' duration were included.
Interventions:
Colonoscopy with 4-quadrant biopsies and targeted biopsies of macroscopic lesions and time-gated fluorescence-guided colonoscopy were performed 2 weeks apart by 2 blinded endoscopists. Three independent pathologists examined the biopsy specimens.
Main Outcome Measurements:
The primary outcome criterion was detection rate of invisible flat intraepithelial neoplasia.
Results:
Invisible flat intraepithelial neoplasia was detected in 3 (7%) patients by white light 4-quadrant biopsies and in 10 (24%) patients by fluorescence-guided endoscopy (P = .02). The sensitivity and specificity for differentiating patients with and without dysplasia were 100% and 81%, respectively. Dysplastic and nondysplastic mucosa could be discriminated with a sensitivity and specificity of 73% and 81%, respectively.
Limitations:
The trial was not randomized.
Conclusion:
The detection rate of intraepithelial neoplasia in patients with ulcerative colitis can be improved by fluorescence-guided colonoscopy.
