title: Endocytoscopic narrow-band imaging efficiency for evaluation of inflammatory activity in ulcerative colitis.
abstract: OBJECTIVE
  To assess the efficacy of endocytoscopic narrow-band 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%, 100%, 61.0%, and 69.2%, respectively. Compared with conventional endoscopy, EC-NBI was superior in diagnostic specificity, negative predictive value, and accuracy (P<0.001, P=0.001 and P=0.047, respectively).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Yasuharu Maeda, Kazuo Ohtsuka, Shin-ei Kudo, Kunihiko Wakamura, Yuichi Mori, Noriyuki Ogata, Yoshiki Wada, Masashi Misawa, Akihiro Yamauchi, Seiko Hayashi, Toyoki Kudo, Takemasa Hayashi, Hideyuki Miyachi, Fuyuhiko Yamamura, Fumio Ishida, Haruhiro Inoue, Digestive Disease Center, Showa University Northern Yokohama Hospital, Kanagawa 2248503, Japan.
authors.forename: Yasuharu
authors.initials: Y
authors.lastname: Maeda
authors.affiliation: Yasuharu Maeda, Kazuo Ohtsuka, Shin-ei Kudo, Kunihiko Wakamura, Yuichi Mori, Noriyuki Ogata, Yoshiki Wada, Masashi Misawa, Akihiro Yamauchi, Seiko Hayashi, Toyoki Kudo, Takemasa Hayashi, Hideyuki Miyachi, Fuyuhiko Yamamura, Fumio Ishida, Haruhiro Inoue, Digestive Disease Center, Showa University Northern Yokohama Hospital, Kanagawa 2248503, Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Ohtsuka
authors.affiliation: Yasuharu Maeda, Kazuo Ohtsuka, Shin-ei Kudo, Kunihiko Wakamura, Yuichi Mori, Noriyuki Ogata, Yoshiki Wada, Masashi Misawa, Akihiro Yamauchi, Seiko Hayashi, Toyoki Kudo, Takemasa Hayashi, Hideyuki Miyachi, Fuyuhiko Yamamura, Fumio Ishida, Haruhiro Inoue, Digestive Disease Center, Showa University Northern Yokohama Hospital, Kanagawa 2248503, Japan.
authors.forename: Shin-ei
authors.initials: SE
authors.lastname: Kudo
authors.affiliation: Yasuharu Maeda, Kazuo Ohtsuka, Shin-ei Kudo, Kunihiko Wakamura, Yuichi Mori, Noriyuki Ogata, Yoshiki Wada, Masashi Misawa, Akihiro Yamauchi, Seiko Hayashi, Toyoki Kudo, Takemasa Hayashi, Hideyuki Miyachi, Fuyuhiko Yamamura, Fumio Ishida, Haruhiro Inoue, Digestive Disease Center, Showa University Northern Yokohama Hospital, Kanagawa 2248503, Japan.
authors.forename: Kunihiko
authors.initials: K
authors.lastname: Wakamura
authors.affiliation: Yasuharu Maeda, Kazuo Ohtsuka, Shin-ei Kudo, Kunihiko Wakamura, Yuichi Mori, Noriyuki Ogata, Yoshiki Wada, Masashi Misawa, Akihiro Yamauchi, Seiko Hayashi, Toyoki Kudo, Takemasa Hayashi, Hideyuki Miyachi, Fuyuhiko Yamamura, Fumio Ishida, Haruhiro Inoue, Digestive Disease Center, Showa University Northern Yokohama Hospital, Kanagawa 2248503, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Mori
authors.affiliation: Yasuharu Maeda, Kazuo Ohtsuka, Shin-ei Kudo, Kunihiko Wakamura, Yuichi Mori, Noriyuki Ogata, Yoshiki Wada, Masashi Misawa, Akihiro Yamauchi, Seiko Hayashi, Toyoki Kudo, Takemasa Hayashi, Hideyuki Miyachi, Fuyuhiko Yamamura, Fumio Ishida, Haruhiro Inoue, Digestive Disease Center, Showa University Northern Yokohama Hospital, Kanagawa 2248503, Japan.
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Ogata
authors.affiliation: Yasuharu Maeda, Kazuo Ohtsuka, Shin-ei Kudo, Kunihiko Wakamura, Yuichi Mori, Noriyuki Ogata, Yoshiki Wada, Masashi Misawa, Akihiro Yamauchi, Seiko Hayashi, Toyoki Kudo, Takemasa Hayashi, Hideyuki Miyachi, Fuyuhiko Yamamura, Fumio Ishida, Haruhiro Inoue, Digestive Disease Center, Showa University Northern Yokohama Hospital, Kanagawa 2248503, Japan.
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Wada
authors.affiliation: Yasuharu Maeda, Kazuo Ohtsuka, Shin-ei Kudo, Kunihiko Wakamura, Yuichi Mori, Noriyuki Ogata, Yoshiki Wada, Masashi Misawa, Akihiro Yamauchi, Seiko Hayashi, Toyoki Kudo, Takemasa Hayashi, Hideyuki Miyachi, Fuyuhiko Yamamura, Fumio Ishida, Haruhiro Inoue, Digestive Disease Center, Showa University Northern Yokohama Hospital, Kanagawa 2248503, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Misawa
authors.affiliation: Yasuharu Maeda, Kazuo Ohtsuka, Shin-ei Kudo, Kunihiko Wakamura, Yuichi Mori, Noriyuki Ogata, Yoshiki Wada, Masashi Misawa, Akihiro Yamauchi, Seiko Hayashi, Toyoki Kudo, Takemasa Hayashi, Hideyuki Miyachi, Fuyuhiko Yamamura, Fumio Ishida, Haruhiro Inoue, Digestive Disease Center, Showa University Northern Yokohama Hospital, Kanagawa 2248503, Japan.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Yamauchi
authors.affiliation: Yasuharu Maeda, Kazuo Ohtsuka, Shin-ei Kudo, Kunihiko Wakamura, Yuichi Mori, Noriyuki Ogata, Yoshiki Wada, Masashi Misawa, Akihiro Yamauchi, Seiko Hayashi, Toyoki Kudo, Takemasa Hayashi, Hideyuki Miyachi, Fuyuhiko Yamamura, Fumio Ishida, Haruhiro Inoue, Digestive Disease Center, Showa University Northern Yokohama Hospital, Kanagawa 2248503, Japan.
authors.forename: Seiko
authors.initials: S
authors.lastname: Hayashi
authors.affiliation: Yasuharu Maeda, Kazuo Ohtsuka, Shin-ei Kudo, Kunihiko Wakamura, Yuichi Mori, Noriyuki Ogata, Yoshiki Wada, Masashi Misawa, Akihiro Yamauchi, Seiko Hayashi, Toyoki Kudo, Takemasa Hayashi, Hideyuki Miyachi, Fuyuhiko Yamamura, Fumio Ishida, Haruhiro Inoue, Digestive Disease Center, Showa University Northern Yokohama Hospital, Kanagawa 2248503, Japan.
authors.forename: Toyoki
authors.initials: T
authors.lastname: Kudo
authors.affiliation: Yasuharu Maeda, Kazuo Ohtsuka, Shin-ei Kudo, Kunihiko Wakamura, Yuichi Mori, Noriyuki Ogata, Yoshiki Wada, Masashi Misawa, Akihiro Yamauchi, Seiko Hayashi, Toyoki Kudo, Takemasa Hayashi, Hideyuki Miyachi, Fuyuhiko Yamamura, Fumio Ishida, Haruhiro Inoue, Digestive Disease Center, Showa University Northern Yokohama Hospital, Kanagawa 2248503, Japan.
authors.forename: Takemasa
authors.initials: T
authors.lastname: Hayashi
authors.affiliation: Yasuharu Maeda, Kazuo Ohtsuka, Shin-ei Kudo, Kunihiko Wakamura, Yuichi Mori, Noriyuki Ogata, Yoshiki Wada, Masashi Misawa, Akihiro Yamauchi, Seiko Hayashi, Toyoki Kudo, Takemasa Hayashi, Hideyuki Miyachi, Fuyuhiko Yamamura, Fumio Ishida, Haruhiro Inoue, Digestive Disease Center, Showa University Northern Yokohama Hospital, Kanagawa 2248503, Japan.
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Miyachi
authors.affiliation: Yasuharu Maeda, Kazuo Ohtsuka, Shin-ei Kudo, Kunihiko Wakamura, Yuichi Mori, Noriyuki Ogata, Yoshiki Wada, Masashi Misawa, Akihiro Yamauchi, Seiko Hayashi, Toyoki Kudo, Takemasa Hayashi, Hideyuki Miyachi, Fuyuhiko Yamamura, Fumio Ishida, Haruhiro Inoue, Digestive Disease Center, Showa University Northern Yokohama Hospital, Kanagawa 2248503, Japan.
authors.forename: Fuyuhiko
authors.initials: F
authors.lastname: Yamamura
authors.affiliation: Yasuharu Maeda, Kazuo Ohtsuka, Shin-ei Kudo, Kunihiko Wakamura, Yuichi Mori, Noriyuki Ogata, Yoshiki Wada, Masashi Misawa, Akihiro Yamauchi, Seiko Hayashi, Toyoki Kudo, Takemasa Hayashi, Hideyuki Miyachi, Fuyuhiko Yamamura, Fumio Ishida, Haruhiro Inoue, Digestive Disease Center, Showa University Northern Yokohama Hospital, Kanagawa 2248503, Japan.
authors.forename: Fumio
authors.initials: F
authors.lastname: Ishida
authors.affiliation: Yasuharu Maeda, Kazuo Ohtsuka, Shin-ei Kudo, Kunihiko Wakamura, Yuichi Mori, Noriyuki Ogata, Yoshiki Wada, Masashi Misawa, Akihiro Yamauchi, Seiko Hayashi, Toyoki Kudo, Takemasa Hayashi, Hideyuki Miyachi, Fuyuhiko Yamamura, Fumio Ishida, Haruhiro Inoue, Digestive Disease Center, Showa University Northern Yokohama Hospital, Kanagawa 2248503, Japan.
authors.forename: Haruhiro
authors.initials: H
authors.lastname: Inoue
authors.affiliation: Yasuharu Maeda, Kazuo Ohtsuka, Shin-ei Kudo, Kunihiko Wakamura, Yuichi Mori, Noriyuki Ogata, Yoshiki Wada, Masashi Misawa, Akihiro Yamauchi, Seiko Hayashi, Toyoki Kudo, Takemasa Hayashi, Hideyuki Miyachi, Fuyuhiko Yamamura, Fumio Ishida, Haruhiro Inoue, Digestive Disease Center, Showa University Northern Yokohama Hospital, Kanagawa 2248503, Japan.
authors.forename: Shigeharu
authors.initials: S
authors.lastname: Hamatani
mesh_terms: D001706:Biopsy; D002196:Capillaries / Q000276:immunology / Q000473:pathology*; D003093:Colitis, Ulcerative / Q000276:immunology / Q000473:pathology*; D003113:Colonoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000098:blood supply* / Q000276:immunology; D007564:Japan; D008297:Male; D008875:Middle Aged; D062048:Narrow Band Imaging; D011237:Predictive Value of Tests; D012007:Rectum / Q000098:blood supply* / Q000276:immunology; D012189:Retrospective Studies; D012720:Severity of Illness Index; D062606:Tertiary Care Centers
keywords: Endosytoscopy; Histological healing; Magnified endoscopy; Mucosal healing; Narrow-band imaging; Ulcerative colitis