Colour me blue: chromoendoscopy and advanced detection methods in ulcerative colitis

Area of Science:

• Gastroenterology
• Endoscopy
• Inflammatory Bowel Disease (IBD) research

Background:

• Surveillance colonoscopy is crucial for patients with long-standing ulcerative colitis or Crohn's colitis.
• Chromoendoscopy enhances dysplasia detection but was studied with standard-definition colonoscopes.

Purpose of the Study:

• To review recent evidence (2018-2021) on chromoendoscopy techniques for IBD surveillance.
• To evaluate conventional chromoendoscopy, virtual chromoendoscopy, and high-definition imaging.
• To assess the utility of random biopsies in IBD surveillance.

Main Methods:

• Review of randomized controlled trials and meta-analyses published between 2018 and 2021.
• Focus on conventional chromoendoscopy, virtual chromoendoscopy, and high-definition imaging.
• Inclusion of studies on random biopsies for IBD surveillance.

Main Results:

• Chromoendoscopy increases dysplasia detection, even with high-definition colonoscopes.
• Procedure time increases with chromoendoscopy; no significant difference in diagnostic yield between high-definition alone and with chromoendoscopy.
• Virtual chromoendoscopy shows limited value for IBD surveillance.

Conclusions:

• High-definition colonoscopy combined with conventional chromoendoscopy are essential for IBD surveillance.
• Further research may be needed to optimize surveillance protocols.
• Virtual chromoendoscopy is not currently recommended for IBD surveillance.