Rediscovering histology: what is new in endoscopy for inflammatory bowel disease?

Abstract

The potential of endoscopic evaluation in the management of inflammatory bowel diseases (IBD) has undoubtedly grown over the last few years. When dealing with IBD patients, histological remission (HR) is now considered a desirable target along with symptomatic and endoscopic remission, due to its association with better long-term outcomes. Consequently, the ability of endoscopic techniques to reflect microscopic findings in vivo without having to collect biopsies has become of upmost importance. In this context, a more accurate evaluation of inflammatory disease activity and the detection of dysplasia represent two mainstay targets for IBD endoscopists. New diagnostic technologies have been developed, such as dye-less chromoendoscopy, endomicroscopy, and molecular imaging, but their real incorporation in daily practice is not yet well defined. Although dye-chromoendoscopy is still recommended as the gold standard approach in dysplasia surveillance, recent research questioned the superiority of this technique over new advanced dye-less modalities [narrow band imaging (NBI), Fuji intelligent color enhancement (FICE), i-scan, blue light imaging (BLI) and linked color imaging (LCI)]. The endoscopic armamentarium might also be enriched by new video capsule endoscopy for monitoring disease activity, and high expectations are placed on the application of artificial intelligence (AI) systems to reduce operator-subjectivity and inter-observer variability. The goal of this review is to provide an updated insight on contemporary knowledge regarding new endoscopic techniques and devices, with special focus on their role in the assessment of disease activity and colorectal cancer surveillance.

New Diagnostic Possibilities for Determining the Activity of Ulcerative Colitis: The Role of Neutrophils

“…У пациентов с обострением ЯК присутствуют и другие признаки воспаления: обнаруживаются группы нейтрофилов в собственной пластинке слизистой оболочки, нейтрофилы проникают в поверхностный эпителий и в эпителий крипт с образованием «криптабсцессов», определяются эрозии и грануляционная ткань. Эти признаки свидетельствуют об активности процесса и в фазу обострения наблюдаются на фоне признаков хронизации, исчезая при неактивном ЯК [11].…”

Editorial: Game Changers in Inflammatory Bowel Diseases

“…The new pan-enteric video capsules with latest technologies provide more effective inflammation detection. The benefits of artificial intelligence system are reduction of operator-subjectivity and inter-observer variability ( 2 ). In the near future, artificial intelligence can be a useful tool in the real-time assistance of doctors' diagnostic decisions during endoscopy in everyday practice.…”

Advanced technology for assessment of endoscopic and histological activity in ulcerative colitis: a systematic review and meta-analysis

“…As a result, these advanced endoscopic technologies are increasingly being adopted in routine clinical practice. 5 , 6 , 10 However, although previous studies have assessed the accuracy of these technologies in diagnosing histological remission, 8 there are limited data making direct comparisons of diagnostic accuracy between the different technologies (i.e. SD-WLE versus HD-WLE versus VCE).…”