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Evaluation of Versatile Intelligent Staining Technology (VIST) and Spectral Flexible Imaging (SFI) for Detection and Optical Characterization of Colorectal Lesions: A Prospective Randomized Controlled Study (INSIGHT)

26. august 2026 opdateret af: Alexandre Vontobel Padoin

Evaluation of Versatile Intelligent Staining Technology (VIST) and Spectral Flexible Imaging (SFI) for Detection and Optical Characterization of Colorectal Lesions: A Prospective Randomized Controlled Study (INSIGHT Study)

This prospective randomized controlled study aims to evaluate the diagnostic accuracy of Versatile Intelligent Staining Technology (VIST) and Spectral Flexible Imaging (SFI) for detection and optical characterization of colorectal lesions during colonoscopy. The performance of VIST and SFI will be compared with high-definition white light endoscopy (WLE), using histopathology as the reference standard and established endoscopic classifications (Paris, Kudo, and JNET). The study will also assess adenoma detection rate, serrated lesion detection, inter- and intraobserver agreement, and procedure-related metrics.

Studieoversigt

Status

Ikke rekrutterer endnu

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

This prospective randomized controlled study will compare high-definition white light endoscopy (WLE), Versatile Intelligent Staining Technology (VIST), and Spectral Flexible Imaging (SFI) for the detection and optical characterization of colorectal lesions during colonoscopy.

Participants will be randomized in a 1:1:1 ratio to one of the three imaging modalities. During the first-look withdrawal phase, the colon will be examined using the allocated modality. Detected lesions will be documented and characterized in vivo according to their location, size, morphology, and established endoscopic classification systems, including the Paris, Kudo, and JNET classifications. Lesions will subsequently be biopsied or resected as clinically appropriate and submitted for histopathological evaluation, which will serve as the reference standard for diagnostic performance analyses.

Standardized recordings of colorectal lesions will also be used for blinded review to assess interobserver and intraobserver agreement in optical diagnosis and endoscopic classification. In addition to evaluating lesion detection and characterization, the study will compare procedural quality metrics and safety across the imaging modalities.

The study is designed to determine whether VIST or SFI can improve colorectal lesion detection and optical characterization compared with conventional high-definition white light endoscopy.

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

990

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiekontakt

Studiesteder

    • Rio Grande do Sul
      • Porto Alegre, Rio Grande do Sul, Brasilien, 90160-090
        • Hospital Sao Lucas da PUCRS
        • Kontakt:

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

  • Voksen
  • Ældre voksen

Tager imod sunde frivillige

Ingen

Beskrivelse

Inclusion Criteria:

  • Age ≥ 18 years
  • Undergoing screening or surveillance colonoscopy
  • Adequate bowel preparation (Boston Bowel Preparation Scale ≥6, with ≥2 per segment)
  • Ability to understand and sign informed consent

Exclusion Criteria:

  • History of inflammatory bowel disease (Crohn's disease or ulcerative colitis)
  • Prior colorectal resection
  • Colorectal stenosis preventing scope progression
  • Pregnancy or breastfeeding
  • Inadequate bowel preparation
  • Clinical contraindication to colonoscopy

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Diagnostisk
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Aktiv komparator: White Light Endoscopy (WLE)
Participants randomized to this arm will undergo colonoscopy using high-definition white light endoscopy (WLE) during the first-look withdrawal phase. Colorectal lesions detected during this phase will be documented and optically characterized according to the study protocol. Detected lesions will be biopsied or resected as clinically appropriate and submitted for histopathological evaluation.
Colonoscopy performed using high-definition white light imaging.
Andre navne:
  • WLE
Eksperimentel: Versatile Intelligent Staining Technology (VIST)
Participants randomized to this arm will undergo colonoscopy using Versatile Intelligent Staining Technology (VIST) during the first-look withdrawal phase. Colorectal lesions detected during this phase will be documented and optically characterized according to the study protocol. Detected lesions will be biopsied or resected as clinically appropriate and submitted for histopathological evaluation.
Colonoscopy performed using Versatile Intelligent Staining Technology (VIST).
Andre navne:
  • VIST
Eksperimentel: Spectral Flexible Imaging (SFI)
Participants randomized to this arm will undergo colonoscopy using Spectral Flexible Imaging (SFI) during the first-look withdrawal phase. Colorectal lesions detected during this phase will be documented and optically characterized according to the study protocol. Detected lesions will be biopsied or resected as clinically appropriate and submitted for histopathological evaluation.
Colonoscopy performed using Spectral Flexible Imaging (SFI).
Andre navne:
  • SFI

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Adenoma Detection Rate (ADR)
Tidsramme: During index colonoscopy.
Proportion of participants with ≥1 colorectal polyp detected during the first-look withdrawal phase using the allocated imaging modality.
During index colonoscopy.

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Serrated Lesion Detection Rate
Tidsramme: During index colonoscopy.
Proportion of participants with ≥1 serrated lesion (e.g., sessile serrated lesion or hyperplastic polyp) detected during the first-look withdrawal phase using the allocated imaging modality, with histopathology confirmation when available.
During index colonoscopy.
Diagnostic Accuracy for Optical Characterization (Neoplastic vs Non-neoplastic)
Tidsramme: During index colonoscopy with post-procedure histopathology results.
Sensitivity, specificity, PPV, NPV, and overall accuracy of optical diagnosis for neoplastic versus non-neoplastic colorectal lesions, using histopathology as the reference standard.
During index colonoscopy with post-procedure histopathology results.
Agreement Between Optical Diagnosis and Histopathology
Tidsramme: During index colonoscopy with post-procedure histopathology results.
Agreement (Cohen's kappa) between in vivo optical diagnosis and histopathology for colorectal lesions.
During index colonoscopy with post-procedure histopathology results.
Concordance of Endoscopic Classifications With Histopathology
Tidsramme: During index colonoscopy with post-procedure histopathology results.
Agreement (Cohen's kappa) between endoscopic classifications (Paris, Kudo pit pattern, and JNET) assigned in vivo and histopathology.
During index colonoscopy with post-procedure histopathology results.
Interobserver and Intraobserver Agreement From Blinded Video Review
Tidsramme: Up to 12 months after index colonoscopy (video-based assessment).
Interobserver and intraobserver agreement (Cohen's kappa) for optical diagnosis and classification based on standardized video recordings of lesions reviewed independently and blinded to group allocation and histopathology.
Up to 12 months after index colonoscopy (video-based assessment).
Procedure Quality Metrics
Tidsramme: During index colonoscopy.
Withdrawal time (minutes), total procedure time (minutes), and cecal intubation rate.
During index colonoscopy.
Safety (Procedure-related Adverse Events)
Tidsramme: Up to 24 hours after colonoscopy.
Incidence of colonoscopy-related adverse events (e.g., bleeding, perforation, post-polypectomy complications).
Up to 24 hours after colonoscopy.

Samarbejdspartnere og efterforskere

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Sponsor

Samarbejdspartnere

Datoer for undersøgelser

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Studer store datoer

Studiestart (Anslået)

1. oktober 2026

Primær færdiggørelse (Anslået)

31. januar 2027

Studieafslutning (Anslået)

31. august 2028

Datoer for studieregistrering

Først indsendt

26. august 2026

Først indsendt, der opfyldte QC-kriterier

26. august 2026

Først opslået (Faktiske)

1. september 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

1. september 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

26. august 2026

Sidst verificeret

1. august 2026

Mere information

Begreber relateret til denne undersøgelse

Andre undersøgelses-id-numre

  • 00410826.8.0000.5336

Plan for individuelle deltagerdata (IPD)

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UBESLUTET

IPD-planbeskrivelse

The individual participant data (IPD) sharing plan has not yet been determined. Any future sharing of de-identified participant data will be subject to applicable ethical and institutional requirements, participant confidentiality protections, and relevant data protection regulations.

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