Cancer risk in IBD: How to diagnose and how to manage DALM and ALM

Table 1 Studies evaluating advanced endoscopic imaging in adenoma-like mass and dysplasia-associated lesion or mass

Author and reference	Study design	Patients	Technique	Results
Kiesslich et al[20]	Prospective	165	Chromoendoscopy (methylene blue)	Chromoendoscopy detects significantly more IEN compared to conventional colonoscopy
Rutter et al[21]	Prospective	100	Chromoendoscopy (indigo carmine)	Targeted mucosal biopsies detect significantly more IEN than non-targeted biopsies
van den Broek et al[24]	Prospective	50	AFI + NBI + WLE	AFI improves detection of colitis-associated neoplasia.
Hurlstone et al[25]	Prospective	162	MCE (indigo carmine)	MCE significantly increases diagnostic yield of IEN and number of flat lesions with IEN
Hurlstone et al[26]	Prospective	350	MCE (indigo carmine)	MCE significantly increases diagnostic yield of IEN and number of flat lesions with IEN
Kiesslich et al[29]	Prospective	153	Chromoendoscopy (methylene blue) + endomicroscopy	Combination of both techniques detects 4.75-fold more neoplasms and requires 50% less biopsy specimen
Hurlstone et al[30]	Prospective	36	Endomicroscopy	Endomicroscopy can differentiate ALM and DALM in vivo with high accuracy (97%)

IEN: Intraepithelial neoplasia; AFI: Autofluorescence imaging; NBI: Narrow band imaging; WLE: White light endoscopy; MCE: Magnifying chromoendoscopy; ALM: Adenoma-like mass; DALM: Dysplasia-associated lesion or mass.