Advanced colonoscopic imaging using endocytoscopy

Crohn's disease and ulcerative colitis are chronic inflammatory bowel diseases (IBD) causing severe damage of the luminal gastrointestinal tract. Differential diagnosis between both disease entities is sometimes awkward requiring a multifactorial pathway, including clinical and laboratory data, radiological findings, histopathology and endoscopy. Apart from disease diagnosis, endoscopy in IBD plays a major role in prediction of disease severity and extent (i.e. mucosal healing) for tailored patient management and for screening of colitis-associated cancer and its precursor lesions. In this state-of-the-art review, we focus on current applications of endoscopy for diagnosis and surveillance of IBD. Moreover, we will discuss the latest guidelines on surveillance and provide an overview of the most recent developments in the field of endoscopic imaging and IBD.

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“…Technological details of both techniques have been described in detail elsewhere and are not the scope of the present review 23,24 (Fig. 4).…”

Section: New Light For Ibd: Light-emitting Diode and Laser Opticsmentioning

confidence: 99%

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

Sivanathan

Tontini

Möhler

et al. 2018

Digestive Endoscopy

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“…Endocytoscopy typically requires N-acetylcysteine for mucolysis followed by topical application of a staining agent. CLE allows for tissue magnification by illumination with a low power laser light that is reflected through a pinhole and requires either a topical agent or an intravenous fluorescence agent, usually fluorescein sodium, for adequate visualization [60,61]. Magnification assessment by EC allows for the detection of mucosal inflammatory cells, crypt assessment, and nucleus-cytoplasm ratio, whereas CLE can assess crypt architecture, inflammatory cell infiltrate, and vessel architecture but fluorescein does not allow for nuclear visualization and assessment.…”

Section: Endocytoscopy and Endomicroscopymentioning

confidence: 99%

Endoscopy for the Diagnosis of Inflammatory Bowel Disease

Jacobs¹,

Lee²

2019

Endoscopy - Novel Techniques and Recent Advancements

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The diagnosis of inflammatory bowel disease (IBD) and the differentiation between Crohn's disease and ulcerative colitis can be challenging. Colonoscopy with ileoscopy is the useful diagnostic test for patients with suspected inflammatory bowel disease. Esophagogastroduodenoscopy, enteroscopy, and capsule endoscopy all have complementary roles to ileocolonoscopy. Endoscopy not only allows for the visualization of inflammation due to IBD but also for histological analysis, both of which can aid the in proper diagnosis and to exclude other causes of enteritis and colitis. This chapter will describe the use of endoscopy for the diagnosis of IBD.

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“…The endocytoscope can provide both standard white-light and endocytoscopic images under 1.0 % methylene blue and 0.05 % crystal violet staining [21] using a hand-operated lever, and endoscopic treatment can be performed as with a traditional colonoscope. Endocytoscopy enables in vivo observation of nuclei and gland duct lumens in the superficial layer [22,23] Fig. 2), allowing precise prediction of lesion pathology with accuracies between 94 % and 100 % for the identification of adenomas [14,15,24].…”

Section: Ec-cadmentioning

confidence: 99%

Impact of an automated system for endocytoscopic diagnosis of small colorectal lesions: an international web-based study

et al. 2016

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Optical diagnosis of colorectal polyps is expected to improve the cost-effectiveness of colonoscopy, but achieving a high accuracy is difficult for trainees. Computer-aided diagnosis (CAD) is therefore receiving attention as an attractive tool. This study aimed to validate the efficacy of the latest CAD model for endocytoscopy (380-fold ultra-magnifying endoscopy). This international web-based trial was conducted between August and November 2015. A web-based test comprising one white-light and one endocytoscopic image of 205 small colorectal polyps (≤ 10 mm) from 123 patients was undertaken by both CAD and by endoscopists (three experts and ten non-experts from three countries). Outcome measures were accuracy in identifying neoplastic change in diminutive (≤ 5 mm) and small (≤ 10 mm) polyps, and accuracy in predicting post-polypectomy surveillance intervals according to current guidelines for high confidence optical diagnoses of diminutive polyps. Of the 205 small polyps (147 neoplastic and 58 non-neoplastic), 139 were diminutive. CAD was accurate for 89 % (95 % confidence interval [CI] 83 % - 94 %) of diminutive polyps and 89 % (84 % - 93 %) of small polyps, which was significantly greater than results for the non-experts (73 % [71 % - 76 %], < 0.001; and 76 % [74 % - 78 %], < 0.001, respectively) and comparable with the experts' results (90 % [87 % - 93 %], = 0.703; and 91 % [89 % - 93 %], = 0.106, respectively). The surveillance interval predicted by CAD provided 98 % (93 % - 100 %) and 96 % (91 % - 99 %) agreement with pathology-directed intervals of the European and American guidelines, respectively. The use of CAD in endocytoscopy can be effective in the management of diminutive/small colorectal polyps.UMIN Clinical Trial Registry: UMIN000018185.

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Advanced colonoscopic imaging using endocytoscopy

Cited by 15 publications

References 37 publications

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

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

Endoscopy for the Diagnosis of Inflammatory Bowel Disease

Impact of an automated system for endocytoscopic diagnosis of small colorectal lesions: an international web-based study

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