Computer-Aided Diagnosis With Monochromatic Light Endoscopy for Scoring Histologic Remission in Ulcerative Colitis

The evaluation of endoscopic and histologic remission is the cornerstone in drug development treatment planning patients with ulcerative colitis (UC). Treatment targets should be reproducible, easy to assess, predictive further disease course. At this time, continues depend on a human interpretation degree inflammation for it prone variability.1Mohammed Vashist N. Samaan M. Mosli M.H. et al.Endoscopic scoring indices activity colitis.Cochrane Database Syst Rev. 2018; 1: Cd011450PubMed Google Scholar Computer-aided diagnosis (CAD) can improve consistency evaluation. Histology currently best predictor sustained clinical UC.2Lobatón T. Bessissow Ruiz-Cerulla A. al.Prognostic value histological deep remission: prospective multicenter study.United European Gastroenterol J. 6: 765-772Crossref PubMed Scopus (35) In outer extremes spectrum, endoscopy has difficulties delineate subtlety therefore less valuable predict remission.3Ponte Pinho R. Fernandes S. al.Impact remissions recurrence recurrence-free time colitis.Inflamm Bowel Dis. 2017; 23: 2238-2244Crossref (33) active UC, mean intercryptal distance wall thickness crypts increases. Although not incorporated current scores, changes mucosal pericryptal vasculature are associated inflammation.4McLaren W.J. Anikijenko P. Thomas S.G. al.In vivo detection morphological microvascular colon association using fiberoptic confocal imaging (FOCI).Dig Dis Sci. 2002; 47: 2424-2433Crossref (52) Scholar,5Quénéhervé L. David G. Bourreille al.Quantitative assessment architecture computer-based analysis laser endomicroscopy inflammatory bowel diseases.Gastrointest Endosc. 2019; 89: 626-636Abstract Full Text PDF (18) These microscopic vascular only detected by endomicroscopy.5Quénéhervé We describe new CAD technique images from prototype endoscope single short wave-length monochromatic LED light illumination (Fujifilm, Tokyo, Japan). This modality enables real-time (including crypts, capillaries, bleeding) up depth approximately 50–200 ?m (Figure 1). does require additional administration intravenous contrast agents. To optimize optical focus, distal attachment cap used maintain an optimal colonic mucosa. hypothesized that nonremission (a Geboes score ?2B.1: neutrophil infiltration lamina propria) capillary congestion, leakage, bleeding. accumulating increasing inflammation. superficial structures could UC. study, we prospectively assessed UC planned at outpatient clinic University Hospitals Leuven (Belgium) (ethical approval S59405). applied no limits age, duration, or assess complete spectrum phenotype. Patients unspecified disease, Crohn’s colitis, ostomy, total colectomy, ileal pouch anal anastomosis, as well pregnant women, were excluded. Fifty-eight (53% male; median 41 years; interquartile range, 38–56 duration 7.1 2.4–16.4 years) 113 evaluable segments (89% rectum sigmoid) included. White obtained different magnification modes biopsies sampled corresponding region. All scored subscore Mayo (MES) Ulcerative Colitis Endoscopic Index Severity (UCEIS). according score. Based these data, algorithm was built several steps. first step, evaluated presence luminal bleeding related leakage. made based automated feature extraction technique. provided per image indicating number pixels (NPBL). second step pattern morphologic hessian-based vessel recognition extracted map, calculated density vessels pixel. From calculate high (NPHD). Finally, combined 2 steps into 1 correlation 2). takes NPBL account. If high, then classified nonremission. low, NPHD. Images NPHD detects performance (sensitivity 0.79 specificity 0.90) compared UCEIS 0.95 0.69) MES 0.98 0.61), resulting positive 0.83, 0.65, 0.59 algorithm, UCEIS, respectively. Receiver operating characteristics shown Supplementary Material. accuracy (86%) versus (74%) (79%) indicates objective way if target reached. present novel, real-time, specific activity. relevant linked cells wall, but difficult quantify vivo. system optically visualizes without any need agent, application innovative wave length source. developed newly highlighted features allows accuracy. potential provide instant accurate Therefore, promising tool endoscopic/histologic healing treat-to-target approach its state, replace standard confirm other (infections dysplasia). Further validation independent cohort necessary. Next, will explore sensitivity change algorithm. concept provides applications including dysplasia detection. Download .pdf (.2 MB) Help pdf files Datahttps://www.gastrojournal.org/cms/asset/1cb0e7c2-6533-4125-9c4f-4665e4633205/mmc2.mp4Loading ... .mp4 (25.75 Video CME Exam Computer-Aided Diagnosis With Monochromatic Light Endoscopy Scoring Histologic Remission ColitisGastroenterologyVol. 160Issue 1Preview Full-Text