Abstract
Endoscopy is the mainstay of inflammatory bowel disease (IBD) evaluation and the pillar of colorectal cancer surveillance. Endoscopic equipment, both hardware and software, are advancing at an incredible pace. Virtual chromoendoscopy is now widely available, allowing the detection of subtle inflammatory changes, thus reducing the gap between endoscopic and histologic assessment. The progress in the field of artificial intelligence (AI) has been remarkable, and numerous applications are now in an advanced stage of development. Computer-aided diagnosis (CAD) systems are likely to reshape most of the evaluations that are now prerogative of human endoscopists. Furthermore, sophisticated tools such as endocytoscopy and probe-based confocal laser endomicroscopy (pCLE) are enhancing our assessment of inflammation and dysplasia. Finally, pCLE combined with molecular labeling could pave the way to a new paradigm of personalized medicine. This review aims to summarize the main changes that occurred in the field of IBD endoscopy and to explore the most promising novelties.
Highlights
Published: 7 February 2022Inflammatory bowel diseases (IBD) are a group of immune-mediated conditions of the gastrointestinal tract, associated with significant morbidity and reduction in quality of life
The aim of this review is to present the applications of endoscopy in the management of inflammatory bowel disease (IBD) and evaluate the latest advances and future developments (Figure 1)
188 IBD patients at risk of cancer (129 ulcerative colitis (UC), 57 Crohn’s colitis, 2 concurrent PSC), not finding any significant difference between the two techniques (HD WLE neoplasia detection rate = 23.4%, higher resolution endoscopes (HD) virtual chromoendoscopy neoplasia detection rate = 14.9%; p = 0.14). These results suggest that HD itself might overcome the need for chromoendoscopy
Summary
Published: 7 February 2022Inflammatory bowel diseases (IBD) are a group of immune-mediated conditions of the gastrointestinal tract, associated with significant morbidity and reduction in quality of life. The two main types of IBD are Crohn’s disease (CD) and ulcerative colitis (UC). The role of endos in the management of IBD has gained importance over the past two decades. Endoscopy is fundamental for diagnosis [1] and for the follow-up, allowing practitioners to assess the presence of disease activity or remission. Endoscopy is the cornerstone of CRC surveillance [1]. In all these instances, the gastroenterologist evaluates macroscopically the mucosa and collects random or targeted histological samples according to the clinical purpose. Novel techniques, presented below, expand the role of conventional endoscopy and bridge it to histology
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