Poster Session I - A113 PRACTICES AND PERCEPTIONS OF ADVANCED ENDOSCOPIC IMAGING TECHNIQUES FOR COLORECTAL NEOPLASIA DETECTION IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE (IBD): A SURVEY AMONG CANADIAN IBD SPECIALISTS

TL;DR

Canadian IBD specialists prefer virtual chromoendoscopy over dye chromoendoscopy for detecting colorectal neoplasia, with interest in AI-assisted colonoscopy.

Contribution

The study provides insights into current practices and perceptions of advanced endoscopic imaging techniques among Canadian IBD specialists.

Findings

VCE is the most commonly used advanced imaging modality for CRN detection in IBD.

AI-assisted colonoscopy is viewed as promising but requires further research to demonstrate its effectiveness.

Chromoendoscopy techniques face challenges like poor visualization during active inflammation.

Abstract

Dye chromoendoscopy (DCE) and virtual chromoendoscopy (VCE) are recommended as first-line adjuncts in conjunction with high-definition white light endoscopy (HD-WLE) for colorectal neoplasm (CRN) detection in inflammatory bowel disease (IBD).

This study surveyed Canadian IBD specialists to understand their perceptions, preferences, and practices regarding image-enhancement modalities (including DCE, VCE, and Artificial Intelligence (AI)-aided endoscopy) for CRN detection in IBD, to inform future studies and clinical recommendations.

Developed collaboratively by IBD experts and methodologists, the survey assessed physicians’ attitudes toward colonoscopy image-enhancement modalities for CRN surveillance in IBD, evaluating five domains: current practices, familiarity with advanced techniques, perceptions of AI-assisted endoscopy, barriers to adoption, and research priorities. It was distributed to IBD specialists affiliated with the Canadian IBD Research Consortium and conducted per CROSS guidelines.

Of 82 specialists invited, 33 responded (40.2%). Most worked in academic centers (90%); 39.4% managed large IBD practices. VCE was the most used advanced imaging modality (84.8%), followed by DCE (33.3%), HD-WLE plus non-targeted biopsies (33.3%), AI-assisted colonoscopy (18.2%), and HD-WLE alone (6.1%). Although 60.6% considered DCE and VCE similarly effective, drawbacks included need for meticulous bowel preparation (VCE 26.6%, DCE 24.1%) and poor visualization on a background of active inflammation (VCE 26.6%, DCE 12%). AI-assisted colonoscopy was seen as promising for CRN detection; 78.8% agreed randomized controlled trials are needed, and 39.4% would adopt AI if it improved CRN detection by 5% over HD-WLE.

This survey highlights a shift towards VCE over DCE, perceived drawbacks of chromoendoscopy, limited availability and uncertainty regarding AI-assisted colonoscopy, and a desire for future research to demonstrate AI’s utility for CRN detection in IBD.

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