Endoscopy

Autofluorescence inferior for dysplasia surveillance

Colonoscopic surveillance is recommended in patients with longstanding ulcerative colitis to detect dysplasia, but there is debate regarding the optimal method. Chromoendoscopy, which uses a topical dye to highlight mucosal changes, and autofluorescence, which compares the intensity of autofluorescent light emitted between neoplastic and normal tissue, are both superior to white light for dysplasia detection, but they have not been directly compared. In the FIND-UC trial, 210 patients with longstanding ulcerative colitis were randomly assigned for inspection with one of the two imaging techniques. Autofluorescence imaging was found to be inferior to chromoendoscopy, with a mean number of detected dysplastic lesion per patient of 0.13 and 0.37, respectively. The findings suggest that autofluorescence imaging should not be further investigated as an alternative dysplasia surveillance method.

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    Vleugels, J. L. A. et al. Chromoendoscopy versus autofluorescence imaging for neoplasia detection in patients with longstanding ulcerative colitis (FIND-UC): an international, multicentre, randomised controlled trial. Lancet Gastroenterol. Hepatol. https://doi.org/10.1016/S2468-1253(18)30055-4 (2018)

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Dickson, I. Autofluorescence inferior for dysplasia surveillance. Nat Rev Gastroenterol Hepatol 15, 256 (2018). https://doi.org/10.1038/nrgastro.2018.30

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