title: Chromoendoscopy versus narrow band imaging for colonic surveillance in inflammatory bowel disease.
abstract: BACKGROUND
  Mucosal dye spraying (chromoendoscopy [CE]) has been shown in controlled studies to enhance lesion detection in colitis surveillance. Narrow band imaging (NBI) potentially offers a more convenient mode of highlighting mucosal lesions. The primary objectives of this study were to compare CE and NBI in colitis surveillance with respect to lesion detection. A secondary objective was to assess the accuracy of the mucosal pit pattern (Kudo classification) with NBI in predicting mucosal histology.
  
  
  METHODS
  Patients with colitis of 8 years or greater disease duration underwent screening colonoscopy with NBI, followed immediately by CE by 2 endoscopists blinded to each other's results. All lesions were biopsied to confirm histology. Diagnostic yield of each modality for dysplastic lesions. Accuracy of Kudo classification by NBI for neoplasia.
  
  
  RESULTS
  Forty-four participants were enrolled. One hundred forty-four colonic lesions were identified in total. Overall, CE identified more lesions than NBI (131 versus 102, P < 0.001); however, most were nondysplastic. CE detected 23 neoplastic (dysplastic or indefinite for dysplasia) lesions in 11 patients and NBI 20 lesions in 10 patients, P = 0.180. Kudo assessment by NBI had low sensitivity for dysplasia (42%) and modest accuracy (74%) for dysplasia.
  
  
  CONCLUSIONS
  NBI detected fewer lesions than CE in chronic colitis; however, most were not dysplastic. There was a nonsignificant trend in favor of CE for detection of dysplasia. At present, NBI cannot be recommended as an alternative to CE for dysplasia surveillance in colitis.
authors.affiliation: Department of Gastroenterology, St Vincent's Hospital, Melbourne, Australia.
authors.forename: Marios
authors.initials: M
authors.lastname: Efthymiou
authors.forename: Patrick B
authors.initials: PB
authors.lastname: Allen
authors.forename: Andrew C F
authors.initials: AC
authors.lastname: Taylor
authors.forename: Paul V
authors.initials: PV
authors.lastname: Desmond
authors.forename: Chatura
authors.initials: C
authors.lastname: Jayasakera
authors.forename: Peter
authors.initials: P
authors.lastname: De Cruz
authors.forename: Michael A
authors.initials: MA
authors.lastname: Kamm
mesh_terms: D003093:Colitis, Ulcerative / Q000150:complications* / Q000473:pathology; D003111:Colonic Polyps / Q000175:diagnosis*; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000209:etiology; D004396:Coloring Agents; D003424:Crohn Disease / Q000150:complications* / Q000473:pathology; D055088:Early Detection of Cancer / Q000706:statistics & numerical data*; D004724:Endoscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007203:Indigo Carmine; D008297:Male; D008875:Middle Aged; D062048:Narrow Band Imaging; D011230:Precancerous Conditions / Q000175:diagnosis / Q000209:etiology; D011379:Prognosis
chemical_list: D004396:Coloring Agents; D007203:Indigo Carmine