Beyond white light: optical enhancement in conjunction with magnification colonoscopy for the assessment of mucosal healing in ulcerative colitis.
Background and study aimThe I-SCAN optical enhancement (OE) system with magnification is a recently introduced combination of optical and digital electronic virtual chromoendoscopy, which enhances mucosal and vascular details. The aim of this pilot study was to investigate the use of I-SCAN OE in the assessment of inflammatory changes in ulcerative colitis (UC).Patients and methodsA total of 41 consecutive patients with UC and 9 control patients were examined by I-SCAN OE (Pentax Medical, Tokyo, Japan). Targeted biopsies of the imaged areas were obtained. A new optical enhancement score focusing on mucosal and vascular changes was developed. The diagnostic accuracy of I-SCAN OE was calculated against histology using two UC histological scores - Robarts Histopathology Index (RHI) and ECAP (Extent,Chronicity,Activity,Plus additional findings).ResultsThe overall I-SCAN OE score correlated with ECAP (r= 0.70;P< 0.001). The accuracy of the overall I-SCAN OE score to detect abnormalities by ECAP was 80 % (sensitivity 78 %, specificity 100 %). I-SCAN OE vascular and mucosal scores correlated with ECAP (r= 0.65 and 0.71, respectively;P< 0.001). The correlation between overall I-SCAN OE score and RHI wasr= 0.61 (P< 0.01), and the accuracy to detect abnormalities by RHI was 68 % (sensitivity 78 %, specificity 50 %). The majority of patients with Mayo 0 had abnormalities on I-SCAN OE.ConclusionIn UC, the new I-SCAN OE technology accurately identified mucosal inflammation, and correlated well with histological scores of chronic and acute changes.
Division of Gastroenterology, University of Calgary, Calgary, Canada.|Division of Gastroenterology and Institute of Translational Medicine, University of Birmingham, United Kingdom.
Marietta
M
Iacucci
Internal Medicine II, HSK Hospital, Wiesbaden, Germany.
Ralf
R
Kiesslich
Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Canada.
Xianyong
X
Gui
Division of Gastroenterology, University of Calgary, Calgary, Canada.
Remo
R
Panaccione
Division of Gastroenterology, University of Calgary, Calgary, Canada.
Joan
J
Heatherington
Division of Gastroenterology, University of Calgary, Calgary, Canada.
Oluseyi
O
Akinola
Division of Gastroenterology, University of Calgary, Calgary, Canada.|Division of Gastroenterology and Institute of Translational Medicine, University of Birmingham, United Kingdom.
Subrata
S
Ghosh
D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D003093:Colitis, Ulcerative / Q000000981:diagnostic imaging* / Q000473:pathology; D003113:Colonoscopy / Q000295:instrumentation / Q000379:methods*; D003116:Color; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D061848:Optical Imaging / Q000295:instrumentation / Q000379:methods*; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D014945:Wound Healing; D055815:Young Adult