Virtual chromoendoscopy for colitis surveillance
Research type
Research Study
Full title
A feasibility study comparing conventional versus virtual chromoendoscopy for colitis surveillance colonoscopy
IRAS ID
113398
Contact name
Bu'Hussain Hayee
Contact email
Sponsor organisation
King's College Hospital NHS Foundation Trust
Duration of Study in the UK
1 years, 11 months, 30 days
Research summary
Colitis (ulcerative colitis;UC) is an inflammatory bowel disease affecting approximately 1/600 people in the UK, with around 12,000 new cases diagnosed each year. Colitis is associated with an appreciable risk of colorectal cancer development, around 2.5x that of the general population. As such, regular colonoscopy every 1-5 years is an established part of British Society of Gastroenterology guidance, including patients with colitis from Crohn’s disease (not just those with UC).
Unlike ‘usual’ colon cancer, colitis-associated cancer often develops as difficult-to-detect, pre-cancerous areas called ‘dysplasia’.
Chromoendoscopy (CE) uses a water-soluble, temporary dye to highlight the bowel lining during colonoscopy. Since the first clinical trial in 2003, CE has been shown to be superior to basic white-light-endoscopy (WLE) for the detection of dysplasia and is recommended by NICE (CG118;2010).
Although CE costs roughly the same as WLE, it is time-consuming – taking approximately twice as long: up to one hour in total, depending on the technique used. Furthermore, the expertise required means that CE is not practised in most hospitals across the UK. Patients with colitis still, therefore, mostly receive WLE.
New advances in imaging resolution and digital enhancement have created a possible alternative to CE: virtual chromoendoscopy (vCE).It may be that vCE is superior to CE, as the former can also examine surface blood vessels. This may be a key factor, given that the earliest detectable changes in the development of dysplasia are in these superficial structures.
vCE might, therefore, allow early and accurate diagnosis: enabling immediate management of suspicious lesions. Notwithstanding its potential superiority, vCE could at the very least, facilitate shorter examinations, as well as removing the equipment and consumables costs associated with CE.
This study will compare the feasibility of conducting a study, including assessing patient acceptability. Preliminary data about the effectiveness of a vCE-based approach to colitis screening will also be gathered.
REC name
London - Surrey Borders Research Ethics Committee
REC reference
15/LO/1701
Date of REC Opinion
10 Nov 2015
REC opinion
Further Information Favourable Opinion