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.
Abbreviations:
MES (Mayo endoscopic subscore), TXI (texture and color enhancement imaging), UC (ulcerative colitis), WLI (white-light imaging)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: November 29, 2022
Accepted:
November 18,
2022
Received:
July 26,
2022
Publication stage
In Press Journal Pre-ProofFootnotes
DISCLOSURE: All authors disclosed no financial relationships.
This work was supported by a grant from the Japanese Foundation for Research and Promotion of Endoscopy.
Identification
Copyright
© 2022 by the American Society for Gastrointestinal Endoscopy
