Compare Conventional Colonosocpy to Endoscopic AFI, NBI for Dysplasia Detection for Ulcerative Colitis & Cholangitis
Condition: Colitis, Ulcerative; Cholangitis, Sclerosing
MeSH terms: Colitis; Colitis, Ulcerative; Cholangitis; Cholangitis, Sclerosing; Ulcer
Study type: Observational

Summary: 
      This study is being done to:

      To attempt to increase the detection of precancerous colon tissue in patients with chronic
      ulcerative colitis and primary sclerosing cholangitis;

      To determine if an investigational scope that can look at the lining of the colon in
      different ways will help the doctor identify abnormal tissue in patients with chronic
      ulcerative colitis and concurrent primary sclerosing cholangitis; and

      To determine if this investigational scope can accurately detect precancerous or cancerous
      tissue in patients with chronic ulcerative colitis that are known to have had cancerous or
      precancerous tissue in the past.
    

Detailed description: 
      Patients with concurrent chronic ulcerative colitis and primary sclerosing cholangitis or
      patients with chronic ulcerative colitis and known colorectal dysplasia or cancer, presenting
      for surveillance colonoscopy will be recruited. After giving informed consent patients will
      then undergo colonoscopy in a segmental fashion. Colonoscopy with white light will be
      performed to the cecum and examination will be performed on withdrawal. First conventional
      white light will be used to examine the cecum and ascending colon and random biopsies will be
      obtained. All endoscopically apparent lesions will be biopsied separately. Immediately
      following will be examination of that segment of cecum and ascending colon under AFI first,
      then NBI with targeted biopsies of suspicious areas being taken. The AFI and NBI modality
      will be achieved by simply flipping a switch.. If necessary, washing of oozing blood from
      random biopsy sites will be performed., The remainder of the colon will be assessed in like
      fashion: transverse, descending and rectosigmoid. Because high definition endoscopy is the
      default modality, this will be in use throughout the procedure.

      All lesions detected will be documented and biopsied for a maximum of four biopsies per
      suspicious lesion. Note will be taken of which modality resulted in visualization of the
      lesion. Data on the factors under study will be collected: i) disease type (CUC + PSC or CUC
      with known dysplasia), ii) Age, iii) Sex, iv) length of time with disease, v) extent of
      disease, vi) the interaction between iv and v will be collected. In addition, dysplasia
      yes/no will be established after biopsy histology is established and the modality under which
      abnormalities were observed will also be recorded.
    

Observational model: Cohort
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Patients presenting with chronic ulcerative colitis and Primary sclerosing cholangitis
        and/or patients with chronic ulcerative colitis and known colorectal dysplasia or cancer
        needing a surveillance colonoscopy.
      
Keywords: Autofluorescence; Narrow Band; High definition white light