Advances in endoscopic dysplasia detection in inflammatory bowel disease

Table 6 Comparative studies of targeted vs random biopsy strategies in inflammatory bowel disease dysplasia surveillance

Ref.	Biopsy protocol compared	Study design	Key findings
Mooiweer et al[20], 2015	Random biopsies (WLE) vs Targeted (DCE)	Retrospective multicenter	No significant difference in neoplasia detection (11% vs 10%, P = 0.80); questions the routine benefit of CE
Moussata et al[37], 2018	Targeted + Random biopsies (CE)	Prospective multicenter cohort	20% of neoplastic sites detected only by random biopsies; the highest yield in PSC, prior neoplasia, and tubular colon
Wan et al[23], 2021	Targeted (CE) vs Random (WLE) vs Targeted (WLE)	Multicenter RCT with long-term follow-up	CE with targeted biopsies was superior to WLE targeted (9.7% vs 1.9%, P = 0.004); random WLE was also better than WLE targeted alone
Carballal et al[2], 2018	Targeted (CE) vs Random (WLE)	Real-life prospective cohort	CE + targeted biopsies detected significantly more dysplasia than WLE with random biopsies
Gasia et al[3], 2016	Random vs Targeted (WLE, DCE, CLE)	Prospective observational	Random biopsies added minimal yield; targeted approach is more efficient
Günther et al[38], 2011	Targeted vs Random (WLE)	Retrospective analysis	Targeted biopsies are sufficient; random biopsies rarely add additional findings
Hlavaty et al[35], 2011	Targeted vs Random (CLE, DCE, WLE)	Prospective cohort	Targeted biopsies increased yield; CLE is not superior to DCE/WLE for flat lesions
Marion et al[19], 2008	Targeted (CE) vs Random (WLE)	Prospective single center	Targeted CE biopsies identified more dysplasia than random WLE biopsies
Leifeld et al[28], 2015	Targeted (NBI) vs Random (WLE)	RCT	No significant advantage of random biopsies in NBI-guided exams
Hu et al[39], 2021	Random vs Targeted (WLE, CE, VCE)	Retrospective cohort	Low diagnostic yield from random biopsies supports image-enhanced targeted approaches
Watanabe et al[40], 2011	Step biopsy vs Targeted biopsy	Japanese multicenter study	Target biopsy is non-inferior to step biopsy in neoplasia detection; fewer biopsies and reduced invasiveness

WLE: White light endoscopy; CE: Chromoendoscopy; DCE: Dye-based chromoendoscopy; VCE: Virtual chromoendoscopy; CLE: Confocal laser endomicroscopy; PSC: Primary sclerosing cholangitis; RCT: Randomized controlled trial; IBD: Inflammatory bowel disease.