TY - JOUR
T1 - Linked Colour imaging for the detection of polyps in patients with Lynch syndrome: A multicentre, parallel randomised controlled trial
AU - Houwen, Britt B. S. L.
AU - Hazewinkel, Yark
AU - Pellisé, María
AU - Rivero-Sánchez, Liseth
AU - Balaguer, Francesc
AU - Bisschops, Raf
AU - Tejpar, Sabine
AU - Repici, Alessandro
AU - Ramsoekh, D.
AU - Jacobs, Maarten A. J. M.
AU - Schreuder, Ramon-Michel M.
AU - Kaminski, Michal Filip
AU - Rupinska, Maria
AU - Bhandari, Pradeep
AU - van Oijen, Martijn G. H.
AU - Koens, Lianne
AU - Bastiaansen, Barbara A. J.
AU - Tytgat, Kristien M.
AU - Fockens, Paul
AU - Vleugels, Jasper L. A.
AU - Dekker, E.
N1 - Publisher Copyright: © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2022/3
Y1 - 2022/3
N2 - Objective: Despite regular colonoscopy surveillance, colorectal cancers still occur in patients with Lynch syndrome. Thus, detection of all relevant precancerous lesions remains very important. The present study investigates Linked Colour imaging (LCI), an image-enhancing technique, as compared with high-definition white light endoscopy (HD-WLE) for the detection of polyps in this patient group. Design: This prospective, randomised controlled trial was performed by 22 experienced endoscopists from eight centres in six countries. Consecutive Lynch syndrome patients ≥18 years undergoing surveillance colonoscopy were randomised (1:1) and stratified by centre for inspection with either LCI or HD-WLE. Primary outcome was the polyp detection rate (PDR). Results: Between January 2018 and March 2020, 357 patients were randomised and 332 patients analysed (160 LCI, 172 HD-WLE; 6 excluded due to incomplete colonoscopies and 19 due to insufficient bowel cleanliness). No significant difference was observed in PDR with LCI (44.4%; 95% CI 36.5% to 52.4%) compared with HD-WLE (36.0%; 95% CI 28.9% to 43.7%) (p=0.12). Of the secondary outcome parameters, more adenomas were found on a patient (adenoma detection rate 36.3%; vs 25.6%; p=0.04) and a colonoscopy basis (mean adenomas per colonoscopy 0.65 vs 0.42; p=0.04). The median withdrawal time was not statistically different between LCI and HD-WLE (12 vs 11 min; p=0.16). Conclusion: LCI did not improve the PDR compared with HD-WLE in patients with Lynch syndrome undergoing surveillance. The relevance of findings more adenomas by LCI has to be examined further. Trial registration number: NCT03344289.
AB - Objective: Despite regular colonoscopy surveillance, colorectal cancers still occur in patients with Lynch syndrome. Thus, detection of all relevant precancerous lesions remains very important. The present study investigates Linked Colour imaging (LCI), an image-enhancing technique, as compared with high-definition white light endoscopy (HD-WLE) for the detection of polyps in this patient group. Design: This prospective, randomised controlled trial was performed by 22 experienced endoscopists from eight centres in six countries. Consecutive Lynch syndrome patients ≥18 years undergoing surveillance colonoscopy were randomised (1:1) and stratified by centre for inspection with either LCI or HD-WLE. Primary outcome was the polyp detection rate (PDR). Results: Between January 2018 and March 2020, 357 patients were randomised and 332 patients analysed (160 LCI, 172 HD-WLE; 6 excluded due to incomplete colonoscopies and 19 due to insufficient bowel cleanliness). No significant difference was observed in PDR with LCI (44.4%; 95% CI 36.5% to 52.4%) compared with HD-WLE (36.0%; 95% CI 28.9% to 43.7%) (p=0.12). Of the secondary outcome parameters, more adenomas were found on a patient (adenoma detection rate 36.3%; vs 25.6%; p=0.04) and a colonoscopy basis (mean adenomas per colonoscopy 0.65 vs 0.42; p=0.04). The median withdrawal time was not statistically different between LCI and HD-WLE (12 vs 11 min; p=0.16). Conclusion: LCI did not improve the PDR compared with HD-WLE in patients with Lynch syndrome undergoing surveillance. The relevance of findings more adenomas by LCI has to be examined further. Trial registration number: NCT03344289.
KW - colonic polyps
KW - colonoscopy
KW - imaging
KW - inherited cancers
KW - surveillance
UR - http://www.scopus.com/inward/record.url?scp=85102836650&partnerID=8YFLogxK
U2 - https://doi.org/10.1136/gutjnl-2020-323132
DO - https://doi.org/10.1136/gutjnl-2020-323132
M3 - Article
C2 - 34086597
SN - 0017-5749
VL - 71
SP - 553
EP - 560
JO - Gut
JF - Gut
IS - 3
ER -