A randomized trial comparing high definition colonoscopy alone with high definition dye spraying and electronic virtual chromoendoscopy for detection of colonic neoplastic lesions during IBD surveillance colonoscopy

Research output: Contribution to journalArticlepeer-review


  • Gilaad G Kaplan
  • Remo Panaccione
  • Oluseyi Akinola
  • Brendan Cord Lethebe
  • Mark Lowerison
  • Yvette Leung
  • Kerri L Novak
  • Cynthia H Seow
  • Stefan Urbanski
  • Parham Minoo
  • Xianyong Gui

Colleges, School and Institutes

External organisations

  • University of Calgary
  • University of Birmingham


OBJECTIVES: Dye spraying chromoendoscopy (DCE) is recommended for the detection of colonic neoplastic lesions in inflammatory bowel disease (IBD). The majority of neoplastic lesions are visible endoscopically and therefore targeted biopsies are appropriate for surveillance colonoscopy. To compare three different techniques for surveillance colonoscopy to detect colonic neoplastic lesions in IBD patients: high definition (HD), (DCE), or virtual chromoendoscopy (VCE) using iSCAN image enhanced colonoscopy.

METHODS: A randomized non-inferiority trial was conducted to determine the detection rates of neoplastic lesions in IBD patients with longstanding colitis. Patients with inactive disease were enrolled into three arms of the study. Endoscopic neoplastic lesions were classified by the Paris classification and Kudo pit pattern, then histologically classified by the Vienna classification.

RESULTS: A total of 270 patients (55% men; age range 20-77 years, median age 49 years) were assessed by HD (n=90), VCE (n=90), or DCE (n=90). Neoplastic lesion detection rates in the VCE arm was non-inferior to the DCE arm. HD was non-inferior to either DCE or VCE for detection of all neoplastic lesions. In the lesions detected, location at right colon and the Kudo pit pattern were predictive of neoplastic lesions (OR 6.52 (1.98-22.5 and OR 21.50 (8.65-60.10), respectively).

CONCLUSIONS: In this randomized trial, VCE or HD-WLE is not inferior to dye spraying colonoscopy for detection of colonic neoplastic lesions during surveillance colonoscopy. In fact, in this study HD-WLE alone was sufficient for detection of dysplasia, adenocarcinoma or all neoplastic lesions.


Original languageEnglish
Pages (from-to)225-234
Number of pages10
JournalThe American Journal of Gastroenterology
Issue number2
Early online date14 Nov 2017
Publication statusPublished - Feb 2018


  • colonic lesions, colon cancer, inflammatory bowel disease, chromoendoscopy, Kudo pit pattern, Paris classification