Assessing a Endoscopic Mucosal Resection Site Using Different Endoscopic Imaging Methods
| Status: | Completed |
|---|---|
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 1/9/2019 |
| Start Date: | January 2016 |
| End Date: | October 2018 |
Diagnostic Accuracy of Using Colonoscope With Near Focus Capability in Detecting Residual Colorectal Neoplastic Tissue After EMR: a Prospective Study
The purpose of this study is to compare the accuracy of using different endoscopic imaging
technique (white light, white light with near focus, narrow band imaging (NBI), NBI with near
focus) for detection of residual neoplastic tissue at site of prior EMR
technique (white light, white light with near focus, narrow band imaging (NBI), NBI with near
focus) for detection of residual neoplastic tissue at site of prior EMR
Residual neoplasia after EMR is a common. Optimal surveillance protocols are not clearly
defined. There is a need for better imaging modalities to evaluate for residual disease.
Suspected residual tissue can be confirmed with repeat colonoscopy or can be empirically
treated. However, this can lead to either frequent colonoscopy or overtreatment. This
presents more cost and financial burden to the patient. With the introduction of newer
colonscopes that have near focus/zoom capability, it is important to assess whether the near
focus technology offers better accuracy for detection of residual neoplastic tissue. With
better accuracy to confidently rule out residual neoplasia using newer imaging modality,
additional treatment or biopsy at the previous EMR may be avoided. Furthermore, the interval
for surveillance colonscopy can be lengthened.
Hypothesis of the study: Using standard white light with and without near focus does not
provide better sensitivity and negative predictive value compare to narrow band imaging with
and without near focus when assessing previous endoscopic mucosal resection (EMR) site for
residual neoplasia
defined. There is a need for better imaging modalities to evaluate for residual disease.
Suspected residual tissue can be confirmed with repeat colonoscopy or can be empirically
treated. However, this can lead to either frequent colonoscopy or overtreatment. This
presents more cost and financial burden to the patient. With the introduction of newer
colonscopes that have near focus/zoom capability, it is important to assess whether the near
focus technology offers better accuracy for detection of residual neoplastic tissue. With
better accuracy to confidently rule out residual neoplasia using newer imaging modality,
additional treatment or biopsy at the previous EMR may be avoided. Furthermore, the interval
for surveillance colonscopy can be lengthened.
Hypothesis of the study: Using standard white light with and without near focus does not
provide better sensitivity and negative predictive value compare to narrow band imaging with
and without near focus when assessing previous endoscopic mucosal resection (EMR) site for
residual neoplasia
Inclusion Criteria:
- Post-EMR follow up at 6-12 months
Exclusion Criteria:
- Non-corrected coagulopathy
- Pregnancy
- Breast feeding
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