Endocytoscopic narrow-band imaging efficiency for evaluation of inflammatory activity in ulcerative colitis

Abstract

AIM:To assess the efficacy of endocytoscopic narrowband imaging (EC-NBI) for evaluating the severity of inflammation in ulcerative colitis (UC). METHODS:This retrospective study was conducted at a single tertiary care referral center. We included UC patients who underwent colonoscopy with endocytoscopy from July 2010 to December 2013. EC-NBI was performed, and the images were evaluated by assessing visibility, increased vascularization, and the increased calibers of capillaries and were classified as Obscure, Visible or Dilated. Obscure was indicative of inactive disease, while Visible and Dilated were indicative of acute inflammation. This study received Institutional Review Board approval. The primary outcome measures included the diagnostic ability of EC-NBI to distinguish between active and inactive UC on the basis of histological activity. The conventional endoscopic images were classified according to the Mayo endoscopic score. A score of 0 or 1 indicated inactive disease, whereas a score of 2 indicated active disease. RESULTS:Fifty-two patients were enrolled. There was a strong correlation between the EC-NBI findings and the histological assessment (r = 0.871, P < 0.01).The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of EC-NBI for diagnosing acute inflammation were 84.0%, 100%, 87.1%, 100%, and 92.3%, respectively, while those for the Mayo endoscopic score were 100%, 40.7%, and accuracy (P < 0.001, P = 0.001 and P = 0.047, respectively). CONCLUSION:The EC-NBI finding of capillaries in the rectal mucosa was strongly correlated with histological inflammation and aided in the differential diagnosis between active and inactive UC.

Significance of Linked Color Imaging for Predicting the Risk of Clinical Relapse in Ulcerative Colitis

“…Various IEE modalities, including narrow-band imaging (NBI), blue-laser imaging, and LCI, have been developed, among which NBI and LCI are efficacious in evaluating the severity of histological inflammation in UC [20,21,[25][26][27]. IEE has been frequently used in clinical practices, including detection and characterization of sporadic colonic tumor [14][15][16][17][18][19][28][29][30][31], detection of tumor lesion, and diagnosis of histological activity, and has been recently suggested for predicting relapse risk [20,26].…”

Fully automated diagnostic system with artificial intelligence using endocytoscopy to identify the presence of histologic inflammation associated with ulcerative colitis (with video)

“…The use of NBI is a standard practice in performing EC. The effectiveness of using NBI has already been evaluated for both identifying colorectal adenoma 16 and evaluating the inflammatory activity of UC, 11 and Olympus Corp also officially recommends its use as an important option.…”

“…[6][7][8][9] Endocytoscopy (EC; CF Y-0058-I prototype and H290ECI; Olympus Corp), which is performed with a 520-fold ultra-magnifying contact microscope, is comparable with other advanced technologies in terms of prediction of histologic severity. [10][11][12] However, such accuracy using these technologies has been achieved only by experts. Furthermore, interobserver variation in categorizing endoscopic disease activity is widely suspected.…”

Assessment of Mucosal Healing in Inflammatory Bowel Disease

“…The Endocytoscopy System Score (ECSS) shows a strong correlation with histology and good agreement for distinguishing between active and inactive US [35]. These results were confirmed by Maeda et al who evaluated the performance of virtual chromoendoscopy coupled with endocytoscopy (CE-NBI) compared to standard endoscopy in UC [36]. The presence of easily visible and dilated microvessels within the intestinal mucosa identified by CE-NBI was predictive of acute intestinal inflammation (sensitivity (Se) 84%, specificity (Spe) 100%, positive predictive value (PPV) 87% and negative predictive value (NPV) 100%).…”