Endoscopy 2017; 49(06): 553-559
DOI: 10.1055/s-0042-124363
Innovations and brief communications
© Georg Thieme Verlag KG Stuttgart · New York

Beyond white light: optical enhancement in conjunction with magnification colonoscopy for the assessment of mucosal healing in ulcerative colitis

Marietta Iacucci1, 2, Ralf Kiesslich3, Xianyong Gui4, Remo Panaccione1, Joan Heatherington1, Oluseyi Akinola1, Subrata Ghosh1, 2
  • 1Division of Gastroenterology, University of Calgary, Calgary, Canada
  • 2Division of Gastroenterology and Institute of Translational Medicine, University of Birmingham, United Kingdom
  • 3Internal Medicine II, HSK Hospital, Wiesbaden, Germany
  • 4Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, Canada
Further Information

Publication History

submitted 12 September 2016

accepted after revision 05 December 2016

Publication Date:
17 March 2017 (eFirst)

Abstract

Background and study aim The 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 methods A 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).

Results The 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 was r = 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.

Conclusion In UC, the new I-SCAN OE technology accurately identified mucosal inflammation, and correlated well with histological scores of chronic and acute changes.