Z Gastroenterol 2015; 53 - KG280
DOI: 10.1055/s-0035-1559306

Accuracy of the newly introduced FUSE-system for assessment of disease activity in inflammatory bowel diseases (IBD) compared to high-definition endoscopy

H Neumann 1, G Tontini 1, A Nägel 1, T Rath 1, M Vieth 2, M Grauer 1, K Mönkemüller 3, M Neurath 1
  • 1Universitätsklinikum Erlangen, Medizinische Klinik 1, Abteilung für Endoskopie, Erlangen, Deutschland
  • 2Klinikum Bayreuth, Institut für Pathologie, Pathologie, Erlangen, Deutschland
  • 3University of Alabama at Birmingham, Division of Gastroenterology and Hepatology, Basil Hirschowitz Endoscopic Center of Excellence, Birmingham, Vereinigte Staaten

Introduction: In 2013, full-spectrum-endoscopy (FUSE) was introduced as a novel colonoscopy platform. In contrast to other endoscopy systems illumination is achieved by LEDs and not by a xenon light source. In addition, the FUSE-system does not provide high-definition imaging yet. In patients with IBD, precise assessment of disease activity (i.e. mucosal healing) is of paramount importance to predict disease outcome and to guide therapy.

Aims: To determine whether FUSE has the potential to assess disease activity in patients with IBD in comparison to a matched cohort of patients undergoing high-definition white-light endoscopy (HD-WL).

Material & Methods: Consecutive patients with IBD undergoing FUSE colonoscopy were matched to patients with IBD undergoing high-definition white-light endoscopy at the same endoscopy unit. The mucosal vascular pattern and any mucosal abnormalities were recorded. Inflammation in ulcerative colitis was recorded according to Mayo ulcerative endoscopic score (MUES) and in Crohn's disease according to Crohn's Disease Endoscopic Index of Severity (CDEIS). Subsequent to endoscopic characterization targeted biopsies were obtained for histopathological analysis of disease activity.

Results: 85 cases were included. Mean age of patients was 37 years (Range 18 to 72 years). 59% of patients had diagnosis of Crohn's disease and 41% diagnosis of ulcerative colitis. Accuracies of FUSE and HD-WL endoscopy for diagnosis of disease activity in IBD were not statistically significant different (81% versus 76%). In the subgroup analysis FUSE and HD-WL endoscopy yielded in underdiagnosis and overdiagnosis of disease activity in 57% versus 46% and 43% versus 54% of not correctly predicted cases, respectively. Overall, FUSE was more accurate for diagnosis of disease activity in Crohn's disease patients while HD-WL endoscopy was more accurate for diagnosis of disease activity in ulcerative colitis.

Conclusion: Despite the use of LEDs, resulting in a darker image and high-resolution imaging, FUSE seems to be equal effective to high-definition white-light imaging for diagnosis of disease activity in patients with IBD.