Inter-rater Reliability and Accuracy of NBI Score for Activity Evaluation in Ulcerative Colitis

Area of Science:

• Gastroenterology
• Endoscopy
• Inflammatory Bowel Disease (IBD) research

Background:

• Colonoscopy is essential for Ulcerative Colitis (UC) management.
• Accurate assessment of endoscopic inflammation is crucial for effective UC treatment.
• Standard white light (WL) endoscopy may have limitations in defining inflammation grade.

Purpose of the Study:

• To evaluate the accuracy of Virtual Chromoendoscopy (VCE) using Narrow Banding Imaging (NBI) with Near Focus (NF).
• To compare VCE (NBI + NF) and NBI alone against standard WL endoscopy for grading UC inflammation.
• To assess the concordance of endoscopic findings with histological evaluation.

Main Methods:

• A prospective, non-randomized study included 31 UC patients undergoing colonoscopy.
• Images were captured using WL, NBI, and NBI with NF in all colonic segments.
• Endoscopic images were scored by three independent endoscopists and compared with histological results (Nancy Index).

Main Results:

• Inter-rater reliability was good for all scoring methods (MES, NBI, NBI + NF).
• Concordance between standard WL endoscopy (MES) and histology (Nancy Index) was unsatisfactory.
• Concordance between NBI evaluation and the Nancy Index was good to excellent.

Conclusions:

• NBI, particularly with Near Focus, offers improved accuracy in assessing UC endoscopic inflammation.
• Enhanced endoscopic visualization aids in defining disease activity in Inflammatory Bowel Disease (IBD).
• These advanced technologies can potentially guide more effective therapeutic strategies for IBD patients.