Marietta Iacucci1, Marco Daperno2, Mark Lazarev3, Razvan Arsenascu4, Gian Eugenio Tontini5, Oluseyi Akinola6, Xianyong Sean Gui7, Vincenzo Villanacci8, Martin Goetz9, Mark Lowerison10, Brendan Cord Lethebe10, Maurizio Vecchi5, Helmut Neumann11, Subrata Ghosh1, Raf Bisschops12, Ralf Kiesslich13. 1. Division of Gastroenterology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Division of Gastroenterology, Biomedical Research Centre and Institute of Translational Medicine, University of Birmingham, Birmingham, United Kingdom. 2. Division of Gastroenterology, University of Torino, Torino, Italy. 3. Division of Gastroenterology, Johns Hopkins Hospital, Baltimore, Maryland, USA. 4. Division of Gastroenterology, Morristown Medical Center, Atlantic Health System, Morristown, New Jersey, USA. 5. Department of Biomedical Sciences for the Health Division of Gastroenterology IRCCS Policlinico San Donato, University of Milan, Milan, Italy. 6. Division of Gastroenterology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada. 7. Department of Pathology, University of Calgary, Calgary, Alberta, Canada. 8. Institute of Pathology, ASST Spedali Civili, Brescia, Italy. 9. Division of Gastroenterology, University Klinikum, Tubingen, Germany. 10. Department of Community Health Sciences, Clinical Research Unit, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada. 11. Interventional Endoscopy Center, I. Medizinische Klinik und Poliklinik, University Hospital, Mainz, Germany. 12. Department of Gastroenterology and Hepatology, University Hospitals Leuven, KU Leuven, Leuven, Belgium. 13. Division of Gastroenterology, Director of Internal Medicine II, HSK Hospital, Wiesbaden, Germany.
Abstract
BACKGROUND AND AIMS: Endoscopic inflammation and healing are important therapeutic endpoints in ulcerative colitis (UC). We developed and validated a new electronic virtual chromoendoscopy (EVC) score that could reflect the full spectrum of mucosal and vascular changes including mucosal healing in UC. METHODS: Eight participants reviewed a 60-minute training module outlining 3 different i-SCAN modes demonstrating the entire spectrum of inflammatory mucosal and vascular changes in UC. Performance characteristics in endoscopic scoring and predicting the histologic inflammation with EVC (i-SCAN) by using 20 video clips before (pre-test) and after (post-test) were evaluated. Exploratory univariate factor analysis was performed on Paddington International Virtual Chromoendoscopy Score (PICaSSO) covariates for mucosal and vascular score separately. Subsequently, a proportional odds logistic regression model for the prediction of histologic scores was analyzed. RESULTS: The interobserver agreement for Mayo endoscopic score in the pre-test (κ = .85; 95% CI, .78-.90) and the post-test (κ = .85; 95% CI, .77-.90) evaluation were very good. This was also true for the Ulcerative Colitis Endoscopic Index of Severity in the pre-test and post-test score interobserver agreement (κ = .86; 95% CI, .77-.92; and κ = .84; 95% CI, .75-.91, respectively). The interobserver agreement of the PICaSSO endoscopic score was very good in the pre-test and post-test evaluations (κ = .92; 95% CI, .87-.96; and κ = .89; 95% CI, .84-.94, respectively). The accuracy of the overall PICaSSO in assessing histologic abnormalities and inflammation by Harpaz score was 57% (95% CI, 48%-65%), by Robarts Histological Index 72% (95% CI, 64%-79%), and by the extent, chronicity, activity, plus system (full spectrum of histologic changes) 83% (95% CI, 76%-88%). CONCLUSIONS: The EVC score "PICaSSO" showed very good interobserver agreement. The new EVC score may be used to define the endoscopic findings of mucosal and vascular healing in UC and reflected the full spectrum of histologic changes.
BACKGROUND AND AIMS: Endoscopic inflammation and healing are important therapeutic endpoints in ulcerative colitis (UC). We developed and validated a new electronic virtual chromoendoscopy (EVC) score that could reflect the full spectrum of mucosal and vascular changes including mucosal healing in UC. METHODS: Eight participants reviewed a 60-minute training module outlining 3 different i-SCAN modes demonstrating the entire spectrum of inflammatory mucosal and vascular changes in UC. Performance characteristics in endoscopic scoring and predicting the histologic inflammation with EVC (i-SCAN) by using 20 video clips before (pre-test) and after (post-test) were evaluated. Exploratory univariate factor analysis was performed on Paddington International Virtual Chromoendoscopy Score (PICaSSO) covariates for mucosal and vascular score separately. Subsequently, a proportional odds logistic regression model for the prediction of histologic scores was analyzed. RESULTS: The interobserver agreement for Mayo endoscopic score in the pre-test (κ = .85; 95% CI, .78-.90) and the post-test (κ = .85; 95% CI, .77-.90) evaluation were very good. This was also true for the Ulcerative Colitis Endoscopic Index of Severity in the pre-test and post-test score interobserver agreement (κ = .86; 95% CI, .77-.92; and κ = .84; 95% CI, .75-.91, respectively). The interobserver agreement of the PICaSSO endoscopic score was very good in the pre-test and post-test evaluations (κ = .92; 95% CI, .87-.96; and κ = .89; 95% CI, .84-.94, respectively). The accuracy of the overall PICaSSO in assessing histologic abnormalities and inflammation by Harpaz score was 57% (95% CI, 48%-65%), by Robarts Histological Index 72% (95% CI, 64%-79%), and by the extent, chronicity, activity, plus system (full spectrum of histologic changes) 83% (95% CI, 76%-88%). CONCLUSIONS: The EVC score "PICaSSO" showed very good interobserver agreement. The new EVC score may be used to define the endoscopic findings of mucosal and vascular healing in UC and reflected the full spectrum of histologic changes.
Authors: G Pellino; D S Keller; G M Sampietro; V Annese; M Carvello; V Celentano; C Coco; F Colombo; N Cracco; F Di Candido; M Franceschi; S Laureti; G Mattioli; L Pio; G Sciaudone; G Sica; V Villanacci; R Zinicola; S Leone; S Danese; A Spinelli; G Delaini; F Selvaggi Journal: Tech Coloproctol Date: 2020-01-25 Impact factor: 3.781
Authors: Olga Maria Nardone; Alina Bazarova; Pradeep Bhandari; Rosanna Cannatelli; Marco Daperno; Jose Ferraz; Martin Goetz; Xianyong Gui; Bu Hayee; Gert De Hertogh; Mark Lazarev; Ji Li; Adolfo Parra-Blanco; Luca Pastorelli; Remo Panaccione; Vincenzo Occhipinti; Timo Rath; Samuel C L Smith; Uday N Shivaji; Gian Eugenio Tontini; Michael Vieth; Vincenzo Villanacci; Davide Zardo; Raf Bisschops; Ralf Kiesslich; Subrata Ghosh; Marietta Iacucci Journal: United European Gastroenterol J Date: 2022-02-23 Impact factor: 4.623