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
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 colonoscopes 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 colonoscopy can be lengthened.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
DIAGNOSTIC
Masking
NONE
Enrollment
230
Standard endoscopic imaging technique
Near focus mode is used to closely examine the area of prior EMR site.
Narrow band imaging is utilized to examine the area of prior EMR.
Mayo Clinic
Jacksonville, Florida, United States
Positive Recurrent Adenomas Using White Light Imaging
The number of positive diagnoses using white light optical imaging only.
Time frame: approximately 6 to 12 months post endoscopic mucosal resection
Positive Recurrent Adenomas Using White Light Imaging Confirmed by Histology
The number of recurrent adenomas diagnosed positive with white light imaging confirmed by standard histopathology of biopsy.
Time frame: approximately 6 to 12 months post endoscopic mucosal resection
Positive Recurrent Adenomas Using White Light Near Focus Imaging
The number of positive diagnoses using white light near focus optical imaging only.
Time frame: approximately 6 to 12 months post endoscopic mucosal resection
Positive Recurrent Adenomas Using White Light Near Focus Imaging Confirmed by Histology
The number of recurrent adenomas diagnosed positive with white light imaging near focus confirmed by standard histopathology of biopsy.
Time frame: approximately 6 to 12 months post endoscopic mucosal resection
Positive Recurrent Adenomas Using Narrow Band Imaging
The number of positive diagnoses using narrow band optical imaging only.
Time frame: approximately 6 to 12 months post endoscopic mucosal resection
Positive Recurrent Adenomas Using Narrow Band Imaging Confirmed by Histology
The number of recurrent adenomas diagnosed positive with narrow band imaging confirmed by standard histopathology of biopsy.
Time frame: approximately 6 to 12 months post endoscopic mucosal resection
Positive Recurrent Adenomas Using Narrow Band Imaging Near Focus
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NBI with near focus to help closely examine the area of prior EMR site.
Biopsy to assess any evidence of residual neoplasia via standard histopathology assessment
The number of positive diagnoses using narrow band optical imaging near focus only.
Time frame: approximately 6 to 12 months post endoscopic mucosal resection
Positive Recurrent Adenomas Using Narrow Band Imaging Near Focus Confirmed by Histology
The number of recurrent adenomas diagnosed positive with narrow band imaging near focus confirmed by standard histopathology of biopsy.
Time frame: approximately 6 to 12 months post endoscopic mucosal resection
Positive Recurrent Adenomas Using Biopsy
The number of positive diagnoses determined by standard histopathology assessment of biopsy.
Time frame: approximately 6 to 12 months post endoscopic mucosal resection