CC BY-NC-ND 4.0 · Endosc Int Open 2020; 08(01): E41-E49
DOI: 10.1055/a-0990-9375
Original article
Owner and Copyright © Georg Thieme Verlag KG 2020

A novel endoscopic imaging system for quantitative evaluation of colonic mucosal inflammation in patients with quiescent ulcerative colitis

Yusuke Honzawa
1   Department of Gastroenterology and Hepatology, Kyoto University Hospital, Kyoto, Japan
,
Minoru Matsuura
1   Department of Gastroenterology and Hepatology, Kyoto University Hospital, Kyoto, Japan
,
Hirokazu Higuchi
2   Department of Medical Supply, Kyoto University Hospital, Kyoto, Japan
,
Takaki Sakurai
3   Laboratory of Anatomic Pathology, Kyoto University Hospital, Kyoto, Japan
,
Hiroshi Seno
1   Department of Gastroenterology and Hepatology, Kyoto University Hospital, Kyoto, Japan
,
Hiroshi Nakase
4   Department of Gastroenterology and Hepatology, Sapporo Medical University School of Medicine, Sapporo, Japan
› Author Affiliations
Further Information

Publication History

submitted 02 March 2019

accepted after revision 05 July 2019

Publication Date:
08 January 2020 (online)

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Abstract

Background and study aims Mucosal healing (MH) is associated with clinical outcome in ulcerative colitis (UC) patients. In most clinical trials, a Mayo endoscopic subscore (MES) of 0 or 1 is defined as MH. However, several recent studies have reported that clinical outcome is different between UC patients with MES 0 and those with MES 1. In addition, the MES is subjective and may differ among endoscopists. Therefore, a repeatable and objective scoring system is required to distinguish MES 0 from MES 1, even in clinically quiescent UC. Here, we assessed the usefulness of new image-enhancing endoscopic technology, the i-scan TE-c, to quantitatively evaluate colonic inflammation in patients with quiescent UC.

Methods We retrospectively reviewed the data from 52 UC patients in clinical remission who had undergone routine colonoscopy with standard white light. The white-light images were reassessed using the new system, and the degree of colonic mucosal inflammation was quantified according to the MAGIC (Mucosal Analysis of Inflammatory Gravity by i-scan TE-c Image) score. We used the i-scan TE-c system to investigate the association among the MAGIC score, MES, and histologic activity (Geboes score).

Results The MAGIC score was significantly higher in the MES 1 group than in the MES 0 group (P = 0.0034). The MAGIC score significantly correlated with the Geboes score (P = 0.015).

Conclusions Our novel image-enhancing endoscopic system was useful for objective and quantitative evaluation of MH in patients with quiescent UC. Further clinical studies using this imaging system are required to confirm its clinical benefit for the management of UC patients.

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