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Newer vs dye-based chromoendoscopy techniques for IBD diagnosis

The latest issue of Alimentary Pharmacology & Therapeutics compares newer optical and digital chromoendoscopy techniques vs dye-based chromoendoscopy for diagnosis and surveillance in inflammatory bowel disease.

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Recent innovations in gastrointestinal endoscopy have changed our traditional approach to diagnosis and therapy in patients with inflammatory bowel diseases (IBD).

While traditionally used dye-based chromoendoscopy techniques suffer from several limitations that reduce their utility in daily routine practice, newer ‘dye-less’ chromoendoscopy techniques offer a great potential to overcome most of these limitations.

Dr Neumann and colleagues from Germany reviewed available optical and digital chromoendoscopy techniques, by critically discussing their potential for diagnostic and surveillance colonoscopy in patients with IBD.

The research team performed a literature search on the use of dye-less and dye-based chromoendoscopy in IBD patients.

Narrow band imaging is superior to white-light endoscopy in assessing colorectal IBD
Alimentary Pharmacology & Therapeutics

In long-standing IBD, dye-based chromoendoscopy improves detection of dysplasia as well as prediction of inflammatory disease activity, and extent of disease compared with standard video-colonoscopy.

Narrow band imaging (NBI) shows no improvement in dysplasia detection rates compared with white-light endoscopy and dye-based chromoendoscopy.

The team found that NBI results in a suboptimal differentiation of dysplastic from nondysplastic lesions.

No data regarding digital ‘dye-less’ chromoendoscopy techniques for dysplasia detection in IBD are yet available.

The researchers observed that both NBI and i-scan are superior to white-light endoscopy in assessing the activity and extent of colorectal IBD.

Dr Neumann's team concludes, "Although the potential benefits of newer optical and digital dye-less chromoendoscopy techniques over traditionally used DBC are substantial, only dye-based chromoendoscopy can currently be recommended to improve dysplasia detection in long-standing IBD."

"In contrast, ‘dye-less’ chromoendoscopy has the potential to quantify disease activity and mucosal healing in IBD."

Aliment Pharmacol Ther 2013: 38(10): 1198–1208
04 November 2013

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