P3634 - Comparing Virtual Chromoendoscopy to Dye-Spraying Chromoendoscopy and White Light Endoscopy in Screening Patients With Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis

Mohammed El-Dallal, MD¹, Saba Altarawneh, MD², Hyder Said, MD³, Vikas Taneja, MD⁴, Kelsey Anderson, MD⁵, Shaharyar Zuberi, MD⁵, Joseph D. Feuerstein, MD^5
1Marshall University Joan C. Edwards School of Medicine, Huntington, WV; ²Marshall University, Huntington, WV; ³Beth Israel Deaconess Medical Center, Boston, WV; ⁴Beth Israel Deaconess Medical Center (BIDMC), Boston, MA; ⁵Beth Israel Deaconess Medical Center, Boston, MA

Introduction: Patients with inflammatory bowel disease have high risk for colon cancer and surveillance colonoscopy is crucial for early detection of dysplasia and neoplasia for this patient population. Virtual chromoendoscopy (VCE) techniques have shown promise in enhancing lesion detection rates. However, the comparative effectiveness of these methods to the traditional dye-spraying chromoendoscopy (CE) and white light endoscopy (WLE) remains unclear.

Methods: A comprehensive search was performed in electronic databases, including PubMed, EMBASE, and Web of Science, from inception until November 2022. Studies reporting number of detected lesions or number of patients with colonic lesions were included. Studies that reported tandem colonoscopies were excluded. For studies with crossover design, we included data from the first procedure. Random-effect models were used to estimate pooled risk ratios (RR) and 95% confidence intervals (95% CI). Subgroup analyses were conducted based on the study type (randomized (RCT) vs observational) and based on the VCE technique. R version 4.0.5 (R foundation for statistical computing, Vienna, Austria) was used to conduct the statistical analysis.

Results: A total of 4,888 studies were assessed and 16 of them were eligible for our analysis. Of the included studies, two were observational, three had a crossover design, and five were published as abstracts (Table 1). Per patient analysis, VCE improved detecting patients with colonic lesions compared to CE (RR 0.73; 95% CI, 0.59–0.9) and WLE (RR 0.69; 95% CI, 0.54–0.87). However, these findings became statistically insignificant if only RCT were used in the subgroup analysis based on the study type (Figur1 A & C). Per the number of lesion analyses, VCE was not statistically different compared to CE (RR 0.73; 95% CI, 0.50–1.06) or WLE (RR 1.04; 95% CI, 0.65–1.67) (Figure 1. B & D). In the subgroup analysis based on the VCE technique, there were no statistical differences between autofluorescence imaging, Fuji intelligent color enhancement, I-scan, or narrow band imaging compared to CE or WLE.

Discussion: The efficacy of virtual chromoendoscopy in detecting colonic lesions for patients with inflammatory bowel disease seems to be higher when compared to dye-spraying chromoendoscopy and white light colonoscopy. However, it is important to note that these findings are primarily based on observational data and do not hold up when considering only randomized trials.



Disclosures:


Mohammed El-Dallal, MD¹, Saba Altarawneh, MD², Hyder Said, MD³, Vikas Taneja, MD⁴, Kelsey Anderson, MD⁵, Shaharyar Zuberi, MD⁵, Joseph D. Feuerstein, MD⁵. P3634 - Comparing Virtual Chromoendoscopy to Dye-Spraying Chromoendoscopy and White Light Endoscopy in Screening Patients With Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.