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Usefulness of texture and color enhancement imaging in assessing mucosal healing in patients with ulcerative colitis - 21/03/23

Doi : 10.1016/j.gie.2022.11.019 
Yukie Hayashi, MD 1, Kaoru Takabayashi, MD, PhD 2, , Motohiko Kato, MD, PhD 3, Anna Tojo, MD 1, Yasuhiro Aoki, MD 1, Yuya Hagihara, MD 1, Kosuke Yoshida, MD 1, Yusuke Yoshimatsu, MD 1, Hiroki Kiyohara, MD, PhD 1, Shinya Sugimoto, MD, PhD 1, Kosaku Nanki, MD, PhD 1, Yohei Mikami, MD, PhD 1, Tomohisa Sujino, MD, PhD 1, Makoto Mutaguchi, MD, PhD 2, Takaaki Kawaguchi, MD 1, Naoki Hosoe, MD, PhD 2, Naohisa Yahagi, MD, PhD 3, Haruhiko Ogata, MD, PhD 2, Takanori Kanai, MS, PhD 1
1 Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan 
2 Center for Diagnostic and Therapeutic Endoscopy, Keio University School of Medicine, Tokyo, Japan 
3 Division of Research and Development for Minimally Invasive Treatment, Cancer Center, Keio University School of Medicine, Tokyo, Japan 

Reprint requests: Kaoru Takabayashi, MD, PhD, Center for Diagnostic and Therapeutic Endoscopy, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.Center for Diagnostic and Therapeutic EndoscopySchool of MedicineKeio University35 ShinanomachiShinjuku-kuTokyo160-8582Japan

Abstract

Background and aims

Endoscopic remission is known to be defined as a Mayo endoscopic subscore (MES) of ≤1 in patients with ulcerative colitis (UC). However, some individuals experience relapse even after showing endoscopic remission under white-light imaging (WLI), and no tool exists that can detect these individuals. The aim of this study was to clarify the usefulness of texture and color enhancement imaging (TXI) in the assessment of inflammation in patients with UC.

Methods

This was a prospective, single-arm, observational study conducted at a university hospital. From January 2021 to December 2021, 146 UC patients with endoscopic remission were enrolled. Images were evaluated by WLI, TXI, and pathologic evaluation, followed by prognostic studies. The primary endpoint of the study was the cumulative relapse of UC in each TXI score. The secondary endpoints were the association between TXI and pathologic scores, predictors of relapse, and interobserver agreement between the MES and TXI scores.

Results

Patients with TXI score 2 had significantly lower UC relapse-free rates than did those with TXI scores 0-1 (log-rank test, P < .01). When pathologic remission was defined as Matts grade ≤2, the rate of pathologic remission decreased significantly with higher TXI scores (P = .01). In multivariate analysis, TXI score 2 was the only risk factor for UC relapse (P < .01; hazard ratio, 4.16; 95% confidence interval, 1.72-10.04). Interobserver agreement on the TXI score was good (κ = 0.597-0.823).

Conclusion

TXI can be used to identify populations with poor prognosis in MES 1, for whom treatment intensification has been controversial.

El texto completo de este artículo está disponible en PDF.

Abbreviations : MES, TXI, UC, WLI


Esquema


 DISCLOSURE: All authors disclosed no financial relationships.
 This work was supported by a grant from the Japanese Foundation for Research and Promotion of Endoscopy.


© 2023  American Society for Gastrointestinal Endoscopy. Publicado por Elsevier Masson SAS. Todos los derechos reservados.
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Vol 97 - N° 4

P. 759 - avril 2023 Regresar al número
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