Optical coherence tomography evaluation of ulcerative colitis: the patterns and the comparison with histology.
OBJECTIVE
The optical coherence tomography (OCT) is an imaging modality based on infrared light backscattering properties of tissues. OCT studies documented the disappearance of crypts and the alteration in light backscattering as features of ulcerative colitis (UC) in human colon. This technique should be more and more able to identify tissue microstructures with a resolution that is nearly that of histology (optical biopsy).


OBJECTIVE
To evaluate whether there are OCT patterns specific for UC and to compare the overall technique performance with the histology.


METHODS
A total of 27 patients (20-76 yr) with UC underwent OCT imaging during a total colonoscopy. The OCT images were collected both from affected and normal sites in active UC or disease in remission. Two biopsies of the same sites were acquired. The OCT images were separately scored. Two pathologists blinded to the endoscopic and OCT patterns scored the samples.


RESULTS
Three OCT patterns were identified: the mucosal backscattering alteration (MBA), the delimited dark areas (DDA), and the layered colonic wall (LCW). In colon affected segments of active and UC in remission, these patterns showed a good correspondence with the histology. Moreover, in 14/25 (56%) normal sites above the affected segment, the OCT documented the pathological features, confirmed only in 10/14 by the histology. Thus, the assessed sensitivity and specificity of OCT in normal segments of UC patients have been 100% and 69%, respectively.


CONCLUSIONS
The in vivo OCT correctly detected disease features in endoscopically affected colon segments, but even in apparently normal segments of UC patients.
Familiari
Luigi
L
Department of Medicine and Pharmacology, University Hospital, Messina, Italy.
Strangio
Giuseppe
G
Consolo
Pierluigi
P
Luigiano
Carmelo
C
Bonica
Marisa
M
Barresi
Gaetano
G
Barresi
Valeria
V
Familiari
Pietro
P
D'Arrigo
Graziella
G
Alibrandi
Angela
A
Zirilli
Agata
A
Fries
Walter
W
Scaffidi
Mariagrazia
M
D000328:Adult; D000368:Aged; D003093:Colitis, Ulcerative / Q000473:pathology*; D003113:Colonoscopy; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D016037:Single-Blind Method; D041623:Tomography, Optical Coherence