Comparing Texture and Colour Enhancement Imaging (TXI) with high-definition white-light endoscopy for finding dysplasia during IBD surveillance

A Randomised Paired Design Study of Texture and Colour Enhancement Imaging (TXI) Versus High-definition White Light Endoscopy for Dysplasia Detection in IBD Surveillance.

This will test whether TXI helps doctors find precancerous dysplasia better than standard high-definition white-light colonoscopy in adults with long-standing inflammatory bowel disease having surveillance colonoscopy.

Quick facts

• Phase: Not applicable
• Study type: Interventional
• Enrollment: 219 (estimated)
• Ages: 16 Years and up
• Sex: All
• Sponsor: London North West Healthcare NHS Trust (Academic / other)
• Locations: 1 site (London)
• Trial ID: NCT07271264 on ClinicalTrials.gov

What this trial studies

Texture and Colour Enhancement Imaging (TXI) enhances texture, brightness and colour in white-light endoscopy to make subtle tissue differences more visible. This randomised paired-design study will compare TXI to high-definition white-light endoscopy during surveillance colonoscopies in eligible IBD patients, with dysplasia detection as the key outcome. Participants will undergo colonoscopy at a single centre using both imaging approaches in a randomized sequence to compare lesion detection directly. Early observational data suggest promise, but randomized evidence for dysplasia detection in IBD is lacking.

Who should consider this trial

Good fit: Adults (over 16) with ulcerative colitis involving left-sided or extensive disease or Crohn's disease with ≥50% colonic involvement who have had disease for ≥8 years, or any IBD patient with primary sclerosing cholangitis, and who are scheduled for surveillance colonoscopy.

Not a fit: Patients with active moderate–severe inflammation (MES ≥2 or SES-CD variable ≥2), significant long-segment stenosis, prior colorectal resection, poor bowel prep (BBPS <6 or <2 in any segment), bleeding risks that prevent biopsy, pregnancy, or inability to attend the procedure are excluded and unlikely to benefit from this protocol.

Why it matters

Potential benefit: If successful, TXI could improve detection of precancerous dysplasia during IBD surveillance and help prevent colorectal cancer through earlier intervention.

How similar studies have performed: Early observational studies report that TXI may help predict UC relapse and performed comparably to dye chromoendoscopy for lesion detection in small samples, but no randomized data exist for dysplasia detection in IBD.

Eligibility criteria

Inclusion Criteria:

* Patients \>16 with inflammatory bowel disease undergoing surveillance colonoscopy.
* Patients with Crohn's (L2/L3 Montreal classification) with \>50% colonic involvement OR
* Patients with ulcerative colitis with Extensive or left sided disease (E3 or E2 Montreal classification) for at least 8 years or a diagnosis of Primary sclerosing cholangitis concomitant with IBD.

Exclusion Criteria:

* Disease duration \<8 years unless a diagnosis of PSC
* Incomplete colonoscopy
* BBPS \<6 or \<2 in any segment
* MES ≥2 or any variable of the SES-CD is ≥2 or any stenosis for \>10cm segment (above the rectum)
* Previous colorectal resection
* Thrombocytopaenia (platelet count \<50) or Coagulopathy precluding biopsy
* Anticoagulation that has not been held appropriately prior to the procedure (must be held at least the morning of the procedure).
* Pregnancy
* Unable or unwilling to consent to study participation

Where this trial is running

London

• Central Middlesex Hospital — London, United Kingdom (Recruiting)

Study contacts

• Study coordinator: Jonathan Landy, Consultant Gastroenterologist

Conditions IBD