Review article: new developments in colonic imaging

BACKGROUND: Colonoscopic detection and removal of neoplasia from the colorectum prevent the development of colorectal cancer. Sporadic adenomas and neoplasia associated with ulcerative colitis are frequently missed during colonoscopy, as a result of which, interval cancers might develop. AIM: To review new developments in colonoscopic imaging concerning the detection of neoplasia. METHODS: Medical databases were searched for relevant publications, dealing with advanced endoscopic imaging techniques during colonoscopy. RESULTS: Pancolonic chromoendoscopy has shown to increase the detection of sporadic adenomas and ulcerative colitis associated neoplasia, at the expense of longer examination times. As chromoendoscopy is labour intensive and time-consuming, its widespread use has been hampered. Narrow band imaging is a novel endoscopic imaging technique, which enhances mucosal and vascular details. Recent studies indicate that narrow band imaging has a high yield for neoplasia; however, no improvement compared to standard colonoscopy has been demonstrated. Autofluorescence imaging is another new technique for which blue endoscopic light is used to induce mucosal autofluorescence. So far, preliminary results have shown promising results of autofluorescence imaging for neoplasia detection. CONCLUSION: Whether chromoendoscopy or novel advanced imaging techniques will change current colonoscopic practice depends on results of future studies comparing these different colonoscopic techniques.