DOP18 Advanced optical diagnosis technology for assessment of endoscopic and histological remission in Ulcerative Colitis: A systematic review and meta-analysis
Nardone, O.M.(1);Snir , Y.(2,3);Hodson, J.(4);Cannatelli, R.(1);Labarile, N.(1);Siau, K.(1,5);Hassan, C.(6);Yanai, H.(2,3);Dotan, I.(2,3);Ghosh, S.(1,7,8,9);Iacucci, M.(1,8,9);
(1)University of Birmingham, Institute of Translational Medicine and Institute of Immunology and Immunotherapy, Birmingham, United Kingdom;(2)Rabin Medical Center- Beilinson Campus- Petach-Tikva Israel, Division of Gastroenterology, Petach-Tikva, Israel;(3)Tel Aviv University- Tel Aviv- Israel, Sackler Faculty of Medicine, Tel Aviv, Israel;(4)University Hospitals Birmingham NHS Foundation Trust- Birmingham- UK., Department of Health Informatics-, Birmingham, United Kingdom;(5)Royal Cornwall Hospitals NHS Trust- Truro- UK, Department of Gastroenterology-, Truro, United Kingdom;(6)Nuovo Regina Margherita Hospital- Roma- Italy, Department of Gastroenterology, Rome, Italy;(7)University College Cork- Cork- Ireland, APC Microbiome Ireland- College of Medicine and Health, Cork, Ireland;(8)University of Birmingham and University Hospitals Birmingham NHS Foundation Trust, NIHR Biomedical Research Centre, Birmingham, United Kingdom;(9)University Hospitals Birmingham NHS Trust- Birmingham- UK, NIHR Wellcome Trust Clinical Research Facilities, Birmingham, United Kingdom;
Background
Advanced endoscopic technologies led to significant progress in the definition of endoscopic remission of ulcerative colitis (UC), and correlate better with histological changes, compared to standard endoscopy. However, whilst studies have assessed the diagnostic accuracy of endoscope technologies individually, there is current limited data comparing between technologies. As such, we aimed to compare the correlations between endoscopy and histology disease activity scores across endoscope technologies
Methods
We searched PubMed and Embase in January 2021 for eligible studies reporting the correlation between endoscopy and histology activity scores in UC. Studies were grouped by endoscope technology as standard-definition white light (SD-WLE), high-definition white light (HD-WLE), or electronic virtual chromoendoscopy (VCE), and comparisons made between these groups
Results
A total of N=27 studies were identified, of which N=12 were included in a meta-analysis of correlations between endoscopic and histological activity scores. Combining these returned a pooled correlation coefficient (rho) for the SD-WLE group of 0.61, which did not differ significantly from HD-WLE (rho: 0.79, p=0.140) or VCE (rho: 0.70, p=0.471) [Fig 1a]. In addition, N=4 studies reported the accuracy of endoscopic activity scores on WLE and VCE to diagnose histological remission. Pooling these found significantly higher accuracy for VCE, compared to WLE (risk ratio: 1.13, 95% CI: 1.07-1.19, p<0.001).[Fig 1b]
Conclusion
Activity scores assessed using endoscopy are strongly correlated with activity on histology. VCE appears to have better accuracy for the diagnosis of histological remission in UC, compared to WLE.