Comparison of Surveillance Colonoscopy Techniques in Patients With IBD

Study Overview
=================
Brief Summary
-----------------
We propose a randomized controlled study to determine the detection rates of neoplasia with high definition colonoscopy alone, high definition dye spraying chromoendoscopy or High definition iSCAN virtual chromoendoscopy in patients with long standing colitis (8 years from diagnosis except primary sclerosing cholangitis when surveillance starts at diagnosis) CD or UC. We hypothesized that these novel endoscopic techniques using High definition colonoscopy with virtual chromoendoscopy -iScan 2 and 3 may be superior to high definition colonoscopy alone and similar to using dye spraying chromoendoscopy for detection of dysplasia and neoplasia in patients with long standing IBD. We will aim to demonstrate if we can avoid dye spraying during the procedure and save expense and considerable time. In addition, we can hope to produce evidence and inform the way in which we perform surveillance colonoscopy especially without large number of multiple random biopsies but only few targeted smart and intelligent biopsies using high definition colonoscopy with iSCAN technique as is already the European practice in several centres.

Conditions
-----------------
Inflammatory Bowel Disease

Intervention / Treatment
-----------------
* Procedure: HD Colonoscopy
* Procedure: HD Colonoscopy + iSCAN
* Procedure: HD Colonoscopy + dye spray


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Clinical and histological diagnosis of UC or colonic CD-extensive or pancolitis. UC -CD Disease duration 8 years from diagnosis UC-CD with associated primary sclerosing cholangitis from diagnosis Ulcerative Colitis Activity Index Mayo score 0-1 (inactive disease) Crohn's disease Activity Index - Harvey Bradshaw score <4 (dysplasia detection requires quiescent inflammatory bowel disease) Exclusion Criteria: Known intraepithelial neoplasia or colorectal cancer or other neoplasia Coagulopathy which may prevent biopsies Pregnancy Inability to obtain informed consent

Ages Eligible for Study
-----------------
Minimum Age: 18 Years
Maximum Age: 80 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| HD<br>High Definition Colonoscopy alone | Procedure: HD Colonoscopy<br>* High definition colonoscopy procedure in surveillance colonoscopy<br>|
| HD + iSCAN<br>HD colonoscopy + iSCAN | Procedure: HD Colonoscopy + iSCAN<br> <br> |
| HD + Dye<br>High definition colonoscopy + dye spraying chromoendoscopy | Procedure: HD Colonoscopy + dye spray<br> <br> |

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Detection of neoplasia in the 3 cohorts - high definition colonoscopy, HD colonoscopy + iSCAN, HD colonoscopy + dye chromoendoscopy |  | At the time of procedure | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
Dysplasia, Inflammatory Bowel Disease