scholarly journals Advanced Endoscopic Imaging Techniques for the Study of Colonic Mucosa in Patients with Inflammatory Bowel Disease

2016 ◽  
Vol 54 (1) ◽  
pp. 11-23
Author(s):  
Daniela Ştefănescu ◽  
S.P. Pereira ◽  
M.M. Filip ◽  
A. Săftoiu ◽  
S. Cazacu
Keyword(s):  
Colonic Mucosa ◽  
Narrow Band Imaging ◽  
Imaging Techniques ◽  
Mucosal Healing ◽  
Confocal Laser Endomicroscopy ◽  
Confocal Laser ◽  
Autofluorescence Imaging ◽  
Endoscopic Techniques ◽  
White Light Endoscopy ◽  
Inflammatory Bowel

Background. Crohn’s disease and ulcerative colitis are inflammatory bowel diseases (IBD) associated with colorectal cancer risk in long-standing diseases. In order to assess the colonic mucosa and to discover dysplastic or neoplastic lesions, advanced endoscopic techniques are needed. Such techniques are detailed in this review: chromoendoscopy, autofluorescence imaging (AFI), narrow band imaging (NBI), i-SCAN, Fujinon Intelligent Color Enhancement (FICE) and confocal laser endomicroscopy (CLE). Aim. The aim of the review is to describe and establish the clinical impact of advanced endoscopic techniques, that could be used in IBD patients’examination in order to assess mucosal healing, microscopic inflammation, dysplasia or neoplasia. Materials and Methods. A literature research about new endoscopic approaches of patients with IBD was made. Results. A lot of studies have been performed to reveal which imaging technique might be used for IBD surveillance. Regarding dysplasia or neoplasia detection and mucosal healing or inflammation assessment, CE proved to be superior to white light endoscopy (WLE), while NBI and AFI did not show an encouraging result. I-SCAN did not improve the colonoscopy quality while FICE has been used in a few studies. CLE could be used to characterize a lesion, providing the same results as conventional histology. Conclusion. At the moment, CE is the only technique which has been included in guidelines for IBD surveillance. CLE can be used to assess any lesion detected with WLE during surveillance, while the other imaging techniques require more studies to determine their efficacy or inefficacy.

scholarly journals Deep Learning Algorithm for the Confirmation of Mucosal Healing in Crohn’s Disease, Based on Confocal Laser Endomicroscopy Images

2021 ◽  
Vol 30 (1) ◽  
pp. 59-65
Author(s):  
Anca Loredana Udristoiu ◽  
Daniela Stefanescu ◽  
Gabriel Gruionu ◽  
Lucian Gheorghe Gruionu ◽  
Andreea Valentina Iacob ◽  
...  
Keyword(s):  
Crohn’S Disease ◽  
Deep Learning ◽  
Crohn's Disease ◽  
Colonic Mucosa ◽  
Mucosal Healing ◽  
Machine Learning Algorithms ◽  
Confocal Laser Endomicroscopy ◽  
Confocal Laser ◽  
Normal Colonic Mucosa ◽  
Test Accuracy

Background and Aims: Mucosal healing (MH) is associated with a stable course of Crohn’s disease (CD) which can be assessed by confocal laser endomicroscopy (CLE). To minimize the operator’s errors and automate assessment of CLE images, we used a deep learning (DL) model for image analysis. We hypothesized that DL combined with convolutional neural networks (CNNs) and long short-term memory (LSTM) can distinguish between normal and inflamed colonic mucosa from CLE images. Methods: The study included 54 patients, 32 with known active CD, and 22 control patients (18 CD patients with MH and four normal mucosa patients with no history of inflammatory bowel diseases). We designed and trained a deep convolutional neural network to detect active CD using 6,205 endomicroscopy images classified as active CD inflammation (3,672 images) and control mucosal healing or no inflammation (2,533 images). CLE imaging was performed on four colorectal areas and the terminal ileum. Gold standard was represented by the histopathological evaluation. The dataset was randomly split in two distinct training and testing datasets: 80% data from each patient were used for training and the remaining 20% for testing. The training dataset consists of 2,892 images with inflammation and 2,189 control images. The testing dataset consists of 780 images with inflammation and 344 control images of the colon. We used a CNN-LSTM model with four convolution layers and one LSTM layer for automatic detection of MH and CD diagnosis from CLE images. Results: CLE investigation reveals normal colonic mucosa with round crypts and inflamed mucosa with irregular crypts and tortuous and dilated blood vessels. Our method obtained a 95.3% test accuracy with a specificity of 92.78% and a sensitivity of 94.6%, with an area under each receiver operating characteristic curves of 0.98. Conclusions: Using machine learning algorithms on CLE images can successfully differentiate between inflammation and normal ileocolonic mucosa and can be used as a computer aided diagnosis for CD. Future clinical studies with a larger patient spectrum will validate our results and improve the CNN-SSTM model.

scholarly journals Confocal Laser Endomicroscopy in the Study of Colonic Mucosa in IBD Patients: A Review

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Francesca Salvatori ◽  
Saverio Siciliano ◽  
Francesco Maione ◽  
Dario Esposito ◽  
Stefania Masone ◽  
...  
Keyword(s):  
Colonic Mucosa ◽  
Current Data ◽  
Confocal Laser Endomicroscopy ◽  
Confocal Laser ◽  
High Resolution Imaging ◽  
Bowel Diseases ◽  
Surveillance Programs ◽  
Risk Patients ◽  
Resolution Imaging ◽  
Inflammatory Bowel

Confocal laser endomicroscopy (CLE) is one of several novel methods that provide real-time, high-resolution imaging at a micronscale via endoscopes. CLE and related technologies are often termed “virtual biopsy” as they simulate the images seen in traditional histology. Recently, the use of CLE was reported in the study of colonic mucosa in patients with inflammatory bowel diseases and in particular in patients affected by ulcerative colitis. CLE has the potential to have an important role in management of IBD patients as it can be used to assess the grading of colitis and in detection of microscopic colitis in endoscopically silent segments. Moreover, CLE can be used in surveillance programs especially in high-risk patients. This report aims to evaluate the current data on the application of confocal endomicroscopy in clinical gastroenterology and particularly in the study of colonic mucosa in UC patients.

Confocal Laser Endomicroscopy in the Evaluation of Inflammatory Bowel Disease

2019 ◽  
Vol 25 (8) ◽  
pp. 1302-1312
Author(s):  
Anna M Buchner
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Intestinal Barrier ◽  
Mucosal Healing ◽  
Confocal Laser Endomicroscopy ◽  
Confocal Laser ◽  
Endoscopic Evaluation ◽  
Real Time Visualization ◽  
Inflammatory Bowel

Abstract Inflammatory bowel disease (IBD), including Crohn’s disease and ulcerative colitis, can be effectively monitored with the use of endoscopy. The additional application of small field imaging technology such as confocal laser endomicroscopy CLE during ongoing endoscopic evaluation has led to real-time visualization of mucosal abnormalities and thus in vivo histology. The endomicroscopy (CLE) can improve IBD endoscopic evaluation by identifying seemingly normal-appearing mucosa, assessing the function of the intestinal barrier of the epithelium and vascular permeability, and by characterizing any mucosal lesions, including dysplastic lesions. CLE used during conventional endoscopy could especially facilitate the evaluation of mucosal healing in IBD. In addition, future developments in molecular imaging in IBD may optimize therapeutic approaches by identifying mucosal targets for therapy and determining the reasons for lack of response to specific therapy or subsequent loss of the response.

scholarly journals Rediscovering histology: what is new in endoscopy for inflammatory bowel disease?

2021 ◽  
Vol 14 ◽  
pp. 175628482110056
Author(s):  
Virginia Solitano ◽  
Ferdinando D’Amico ◽  
Mariangela Allocca ◽  
Gionata Fiorino ◽  
Alessandra Zilli ◽  
...  
Keyword(s):  
Disease Activity ◽  
Narrow Band Imaging ◽  
Daily Practice ◽  
Cancer Surveillance ◽  
Special Focus ◽  
High Expectations ◽  
Endoscopic Techniques ◽  
Bowel Diseases ◽  
Inflammatory Bowel

The potential of endoscopic evaluation in the management of inflammatory bowel diseases (IBD) has undoubtedly grown over the last few years. When dealing with IBD patients, histological remission (HR) is now considered a desirable target along with symptomatic and endoscopic remission, due to its association with better long-term outcomes. Consequently, the ability of endoscopic techniques to reflect microscopic findings in vivo without having to collect biopsies has become of upmost importance. In this context, a more accurate evaluation of inflammatory disease activity and the detection of dysplasia represent two mainstay targets for IBD endoscopists. New diagnostic technologies have been developed, such as dye-less chromoendoscopy, endomicroscopy, and molecular imaging, but their real incorporation in daily practice is not yet well defined. Although dye-chromoendoscopy is still recommended as the gold standard approach in dysplasia surveillance, recent research questioned the superiority of this technique over new advanced dye-less modalities [narrow band imaging (NBI), Fuji intelligent color enhancement (FICE), i-scan, blue light imaging (BLI) and linked color imaging (LCI)]. The endoscopic armamentarium might also be enriched by new video capsule endoscopy for monitoring disease activity, and high expectations are placed on the application of artificial intelligence (AI) systems to reduce operator-subjectivity and inter-observer variability. The goal of this review is to provide an updated insight on contemporary knowledge regarding new endoscopic techniques and devices, with special focus on their role in the assessment of disease activity and colorectal cancer surveillance.

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