Beyond conventional endoscopy: Image-enhanced techniques in quiescent ulcerative colitis assessment

Area of Science:

• Gastroenterology
• Endoscopic Imaging
• Inflammatory Bowel Disease

Background:

• Mucosal healing is a key therapeutic goal in ulcerative colitis (UC), linked to better clinical outcomes.
• Conventional endoscopy struggles to detect microscopic inflammation, leading to subjective assessments and interobserver variability.

Purpose of the Study:

• To evaluate the role of image-enhanced endoscopy (IEE) in assessing mucosal healing in UC.
• To explore how IEE techniques improve visualization and objective measurement of UC inflammation compared to conventional methods.

Main Methods:

• Utilized various IEE modalities (NBI, LCI, BLI, DFI, TCEI, iSCAN) to visualize mucosal and vascular patterns.
• Compared IEE findings with histological inflammation and clinical relapse rates.
• Investigated quantitative IEE-based indices for objective assessment.

Main Results:

• IEE modalities enhance visualization of vascular structures and color differences, aiding in precise healing assessment.
• IEE findings correlate strongly with histological inflammation and predict clinical relapse better than conventional scores.
• Quantitative IEE indices provide reproducible, objective measurements, reducing subjective variability.

Conclusions:

• Advanced IEE technologies on next-generation platforms allow real-time, high-resolution evaluation of mucosal healing in UC.
• IEE facilitates earlier detection of residual inflammation, personalized management, and improved long-term outcomes with lower relapse rates.