New endoscopic imaging techniques for the differentiation of polyps in the colon.

Background:

Removal of colonic adenomas prevents the development of colorectal cancer, whereas resection of non-neoplastic lesions expands the endoscopic workload, increases pathology costs and has a risk of complications. Chromoendoscopy (CE), narrow band imaging (NBI) and autofluorescence imaging (AFI) are advanced imaging techniques enabling differentiation of premalignant adenomas and innocent non-neoplastic polyps, however, with insufficient accuracy. Confocal endomicroscopy is a novel imaging technique providing in vivo histology for a more accurate diagnosis during endoscopy.



Aims:

To evaluate the feasibility and accuracy of confocal endomicroscopy during colonoscopic surveillance; (2) To compare the accuracy of CE / NBI / AFI with the accuracy of confocal endomicroscopy for the endoscopic differentiation of adenomatous and non-neoplastic lesions.



Methods:

Patients undergoing colonoscopic surveillance for (serrated) adenomas will be invited for this study. All endoscopically detected lesions will be inspected by CE / NBI / AFI and confocal endomicroscopy for endoscopic prediction of histopathology. Biopsies from those lesions will be used as the gold standard diagnosis.



Outcomes:

1. Feasibility of confocal endomicroscopy (i.e. accuracy and percentage of confocal images with insufficient image quality).

2. Comparison of accuracies of CE, NBI, AFI and confocal endomicroscopy for the endoscopic differentiation of detected lesions.

Several new imaging techniques have been developed in order to improve differentiation of colonic lesions, one of these is confocal endomicroscopy. The objective of the proposed study is to evaluate the feasibility and additional value of confocal endomicroscopy, and to compare confocal endomicroscopy with NBI, AFI and chromoendoscopy.

N/A

N/A