White-Light or Narrow-Band Imaging Colonoscopy in Surveillance of Ulcerative Colitis: A Prospective Multicenter Study

Area of Science:

• Gastroenterology
• Endoscopy
• Oncology

Background:

• Early detection of neoplastic lesions is critical for managing long-standing ulcerative colitis.
• Optimal colonoscopy techniques for identifying these lesions remain debated.

Purpose of the Study:

• To compare the efficacy of white-light (WL) and narrow-band imaging (NBI) colonoscopy with different biopsy strategies for detecting intraepithelial neoplasia (IN) in ulcerative colitis patients.

Main Methods:

• A prospective multicenter study involving patients with long-standing ulcerative colitis.
• Two colonoscopies per patient were performed within 3 months, randomizing the sequence of WL and NBI.
• Biopsy strategies included stepwise random, segmental random, and targeted biopsies for WL, and segmental and targeted biopsies for NBI.

Main Results:

• Intraepithelial neoplasia (IN) was detected in 22.6% of patients (54 lesions).
• NBI with targeted and segmental biopsies detected IN with similar sensitivity to WL with targeted and stepwise biopsies.
• The NBI approach required significantly fewer biopsy specimens and less withdrawal time.

Conclusions:

• Stepwise biopsies are essential for white-light colonoscopy.
• Combining targeted and segmental biopsies with NBI offers comparable sensitivity to WL methods but is more efficient.
• The highest detection sensitivity for neoplastic lesions may be achieved by integrating both WL and NBI techniques.