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Review
. 2022 Dec;10(10):1103-1112.
doi: 10.1002/ueg2.12316. Epub 2022 Oct 12.

New endoscopic tools in inflammatory bowel disease

Olga Maria Nardone  1   2 , Rosanna Cannatelli  1   3 , Subrata Ghosh  4 , Marietta Iacucci  1   5
Affiliations
Review

New endoscopic tools in inflammatory bowel disease

Olga Maria Nardone et al. United European Gastroenterol J. 2022 Dec.

Abstract

Endoscopic remission is now considered the ultimate long-term goal for treating inflammatory bowel disease (IBD). Recent advances in endoscopic techniques have progressively added new tools to the armamentarium of endoscopists for a deeper assessment and characterisation of the intestinal mucosa. Virtual Electronic chromoendoscopy is widely available in the endoscopic units, leading to a more accurate evaluation of the vascular and mucosal architecture of the colon, reducing the gap with histology, which is considered a favourable long-term measure. In addition, advanced, sophisticated techniques such as endocytoscope and confocal laser endomicroscopy provide insights into individualised and personalised IBD therapy. Finally, high expectations are placed on the advent of Artificial Intelligence (AI) with promising applications that have the potential to revolutionise IBD diagnosis and management. Here, we discuss state-of-the-art of endoscopic techniques and their applicability to accurate assess endoscopic and histological remission, predict response to therapy and detect, characterise and guide treatment of colonic dysplastic lesions. We are seeing the dawn of a new era wherein the applications of these new endoscopic tools, hand in hand with AI, offer the most incredible opportunity to deliver precision medicine to patients with IBD.

Keywords: confocal laser endomicroscopy; endocytoscope; endoscopic remission; inflammatory bowel disease; virtual electronic chromoendoscopy.

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Conflict of interest statement

No conflict of interest to declare

Figures

FIGURE 1
FIGURE 1
Paddington International Virtual Chromoendoscopy Score (PICaSSO) and some examples with iscan
FIGURE 2
FIGURE 2
pCLE images of (a) crypts architecture; (b) cell sheddings and plumes of fluorescein; (c) tortuosity of the vessels; (d) leakage of fluorescein. pCLE, probe confocal laser endomicroscopy
FIGURE 3
FIGURE 3
After the application on the mucosa of a mucolytic agent N‐acetylcysteine, (a) honeycomb‐like structure of colonic mucosa with methylene blue 0.2%; endocytoscope images of (b) elongated crypts architecture; (c, d) infilitration of the cells between the crypts; (e) drop out/necrosis of the crypts with infiltration of the cells
FIGURE 4
FIGURE 4
Evolution of endoscopic techniques in Inflammatory Bowel Disease (IBD) from the virtual chromoendoscopy in the present, confocal laser endomicroscopy and endocytoscope in some referral centres, to molecular labelling and Artificial Intelligence (AI) in the next future
See this image and copyright information in PMC

References

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