Assessment of endoscopic healing by using advanced technologies reflects histologic healing in ulcerative colitis.

Iacucci, M, Cannatelli, R, Gui, X S, Zardo, Davide, Bazarova, A, Gkoutos, G, Lethebe, B C, Kaplan, G G, Panaccione, R, Kiesslich, R and Ghosh, S (2020) Assessment of endoscopic healing by using advanced technologies reflects histologic healing in ulcerative colitis. Journal of Crohn's & colitis. ISSN 1876-4479.

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Several studies reported that Ulcerative colitis (UC) patients with endoscopic mucosal healing may still have histologic inflammation. We investigated the relationship between mucosal healing defined by modified PICaSSO (Paddington International Virtual ChromoendoScopy ScOre), Mayo Endoscopic Score (MES) and probe-based confocal laser endomicroscopy (pCLE) with histological indices in UC.


A prospective study enrolling 82 UC patients (M 66%) was conducted. High definition (HD) colonoscopy was performed to evaluate the activity of the disease with MES assessed with High Definition (HD-MES) and modified PICaSSO and targeted biopsies were taken; pCLE was then performed. Receiver Operating Characteristic (ROC) curves were plotted to determine the best thresholds for modified PICaSSO and pCLE scores that predicted histological healing according to the Robarts Histopathology Index (RHI) and ECAP 'Extension, Chronicity, Activity, Plus' histology score.


A modified PICaSSO of ≤4 predicted histological healing at RHI ≤3, with sensitivity, specificity, accuracy and area under the ROC curve (AUROC) of 89.8%, 95.7%, 91.5% and 95.9% respectively. The sensitivity, specificity, accuracy and AUROC of HD-MES to predict histological healing by RHI were 81.4%, 95.7, 85.4% and 92.1%, respectively. A pCLE ≤10 predicted histological healing with sensitivity 94.9%, specificity 91.3%, accuracy of 93.9% and AUROC of 96.5%. An ECAP of ≤10 was predicted by modified PICaSSO ≤4 with accuracy of 91.5% and AUROC of 95.9%.


Histological healing by RHI and ECAP is accurately predicted by HD-MES and modified virtual electronic Chromoendoscopy PICaSSO,endoscopic score ; and the use of pCLE did not improve the accuracy any further.

Item Type: Article
Subjects: WI Digestive system. Gastroenterology
Divisions: Clinical Support > Pathology
Planned IP Care > Gastroentrology
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Depositing User: Mrs Yolande Brookes
Date Deposited: 03 Apr 2020 10:57
Last Modified: 03 Apr 2020 10:57

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