Advanced endoscopic imaging for diagnosis of inflammatory bowel diseases: Present and future perspectives

Sivanathan, Visvakanth; Tontini, Gian Eugenio; Möhler, Markus; Galle, Peter R.; Neumann, Helmut

doi:10.1111/den.13023

Cited by 12 publications

(21 citation statements)

References 46 publications

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“…Previous reports using advanced endoscopic technologies confirmed the efficacy of evaluating microvessels and glandular cavities to predict histological severity and clinical relapse 9‐12,17–23 . In the present study, we found that patients with an MES of 1 in clinical remission with intramucosal capillary network changes and crypt architecture abnormalities were at a high risk of experiencing clinical relapse as well as the presence of histological inflammation 24,25 .…”

Section: Discussionsupporting

confidence: 79%

Endocytoscopic intramucosal capillary network changes and crypt architecture abnormalities can predict relapse in patients with an ulcerative colitis Mayo endoscopic score of 1

Maeda

Kudo

Ogata

et al. 2020

Digestive Endoscopy

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Objectives Recent studies have suggested the necessity of therapeutic intervention for patients with ulcerative colitis at high risk of clinical relapse with a Mayo endoscopic score (MES) of 1. The aim of this retrospective cohort study was to demonstrate the impact of intramucosal capillary network changes and crypt architecture abnormalities to stratify the risk of relapse in patients with an MES of 1. Methods All included patients had an MES of ≤1 and confirmed sustained clinical remission between October 2016 and April 2019. We classified patients with an MES of 1 as “intramucosal capillary/crypt (ICC)‐active” or “ICC‐inactive” using endocytoscopic evaluation. We followed patients until October 2019 or until relapse; the main outcome measure was the difference in clinical relapse‐free rates between ICC‐active and ICC‐inactive patients with an MES of 1. Results We included 224 patients and analyzed data for 218 (82 ICC‐active and 54 ICC‐active with an MES of 1 and 82 with an MES of 0). During follow‐up, among the patients with an MES of 1, 30.5% (95% confidence interval 20.8–41.6; 25/82) of the patients relapsed in the ICC‐active group and 5.6% (95% confidence interval 1.2–15.4; 3/54) of the patients relapsed in the ICC‐inactive group. The ICC‐inactive group had a significantly higher clinical relapse‐free rate compared with the ICC‐active group (P < 0.01). Conclusions In vivo intramucosal capillary network and crypt architecture patterns stratified the risk of clinical relapse in patients with an MES of 1 (UMIN 000032580; UMIN 000036359).

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Section: Discussionsupporting

confidence: 79%

Endocytoscopic intramucosal capillary network changes and crypt architecture abnormalities can predict relapse in patients with an ulcerative colitis Mayo endoscopic score of 1

Maeda

Kudo

Ogata

et al. 2020

Digestive Endoscopy

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“…The usefulness of LCI for evaluating gastritis and colitis has been reported. 12,13 Due to the color contrast enhancement and sufficient brightness of LCI, high detection ability for colorectal polyps has been reported. 14 However, no systematic review or meta-analysis of LCI versus WLI in the detection of colorectal polyps is available to date.…”

Section: Introductionmentioning

confidence: 99%

Colon polyp detection using linked color imaging compared to white light imaging: Systematic review and meta‐analysis

Shinozaki

Kobayashi

Hayashi

et al. 2020

Digestive Endoscopy

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Background and Aim Linked color imaging (LCI) is a novel image‐enhancing technology which enhances color differences between a colorectal lesion and surrounding mucosa with enough brightness to illuminate the wide colorectal lumen. The aim of this study is to compare colorectal polyp detection using LCI with that using white light imaging (WLI). Methods Randomized controlled trials and prospective studies comparing LCI with WLI for colorectal polyp detection were selected. Outcomes included overall polyp/adenoma detection and additional polyp detection at a second observation. Outcomes were documented by pooled risk ratios (RR) with 95% confidence interval (CI) using the Mantel‐Haenszel random effect model. Results Seven studies were included. LCI showed significant superiority for polyp and adenoma detection compared with WLI (RR 1.16, 95% CI 1.09–1.25, P < 0.001 for polyp detection; RR 1.26, 95% CI 1.14–1.39 P < 0.001 for adenoma detection). LCI significantly increased the number of polyps detected per patient compared with WLI (mean difference 0.27, 95% CI 0.01–0.53, P = 0.040). LCI significantly increased the number of adenomas detected per patient compared with WLI (mean difference 0.22, 95% CI 0.08–0.36, P = 0.002). LCI significantly increased the number of flat polyps detected per patient compared with WLI (mean difference 0.14, 95% CI 0.01–0.27, P = 0.040). LCI had a significantly higher rate of additional polyp detection compared with WLI in the right colon (RR 2.68, 95% CI 1.71–4.19, P < 0.001). Conclusions Linked color imaging has significantly greater polyp and adenoma detection rates and detection rate of previously missed polyps compared with WLI. We recommend the initial use of LCI for routine colonoscopy.

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“…A classical description of mucosal friability and loss of vascular pattern are no longer valid, and a new endoscopic language, including crypt architecture, micro-erosions, fine vascular changes around the crypts and distinction between intramucosal and luminal bleeding, has recently been introduced. 58,59…”

Section: Limitation Of White-light Endoscopy To Define Endoscopic Andmentioning

confidence: 99%

“…Several studies have assessed the ability of CLE to assess histologic degree and extension of mucosal inflammation in patients affected by IBD (Figure 1). 59…”

Section: Advanced and Novel Endoscopy Technologies To Assess Mucosal mentioning

confidence: 99%

Can advanced endoscopic techniques for assessment of mucosal inflammation and healing approximate histology in inflammatory bowel disease?

Nardone

Cannatelli

Zardo

et al. 2019

Therap Adv Gastroenterol

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The targets of therapy in inflammatory bowel disease have transformed in the last few years. The standard definition of mucosal healing assessed using white light standard definition endoscopy is being challenged because even when endoscopy suggests mucosal healing, the presence of histological activity can often still be observed. Of note, microscopic signs of inflammation correlate with clinical outcomes such as risk of relapse, hospitalization and colorectal cancer. Therefore, histological healing has increasingly become an important target to achieve. Advanced endoscopic technologies have been developed and many are starting to be adopted in daily clinical practice. They can provide a more detailed view of the mucosal and vascular architecture almost at the histology level, including crypt, vessel architecture and cellular infiltration. So, these can provide a more accurate definition of mucosal and histological healing. In this review we focus on new advanced endoscopic techniques, and how these have the potential to reduce the gap between histological and mucosal healing.

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Advanced endoscopic imaging for diagnosis of inflammatory bowel diseases: Present and future perspectives

Cited by 12 publications

References 46 publications

Endocytoscopic intramucosal capillary network changes and crypt architecture abnormalities can predict relapse in patients with an ulcerative colitis Mayo endoscopic score of 1

Endocytoscopic intramucosal capillary network changes and crypt architecture abnormalities can predict relapse in patients with an ulcerative colitis Mayo endoscopic score of 1

Colon polyp detection using linked color imaging compared to white light imaging: Systematic review and meta‐analysis

Can advanced endoscopic techniques for assessment of mucosal inflammation and healing approximate histology in inflammatory bowel disease?

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