Su1116 Small Bowel Ultrasound Accurately Predicts Post-Operative Endoscopic Recurrence in Crohn's Disease

Abstract

Background & Aim: Recently, mucosal healing assessed by endoscopic findings appears to predict long-term remission in patients with ulcerative colitis (UC), although there is no agreement on clinical, endoscopic or histological scoring system. In most of clinical trial, endoscopic score of Mayo 0 or 1 is defined as mucosal healing in UC patients. However, assessment of endoscopic score of Mayo 0 or 1 is quite different depending on endoscopists. Therefore, to develop the objectively quantitative scoring system that will help to improve patient outcome is required. Emerging endoscopic imaging modalities, including both, vital and virtual chromoendoscopy and magnification endoscopy, enabled endoscopists to visualize and interpret mucosal details. Among them, i-scan is the newly developed imageenhanced endoscopic technology from HOYA/PENTAX (Tokyo, Japan). i-scan TE-c is one of digital transmission method among HOYA/PENTAX EPK-i system in conjunction with EC38-i10M. The aim of study is to assess the significance of new endoscopic imaging system with i-scan TE-c for quantitative evaluation of colonic inflammation in patients with UC. Method: From January 2011 to Aug 2012, a total of 76 UC patients with endoscopic score of Mayo 0 or 1 by standard white light endoscopy were reassessed by i-scan TE-c. We performed white light (WL) colonoscopy in conjunction with i-scan TE-c in UC patients with endoscopic score of Mayo 0 or 1, and the difference of the tone of color between normal and inflamed colonic mucosa was given with a numeric conversion. The intensity and width of inflammatory lesion identified by modified color phase and saturation was given with a numeric conversion and visualized. Results: In 29 of 76 UC patients, endoscopic score of Mayo was estimated as 0. In the remaining 47 patients, that was estimated as 1. The mean i-scan TE-c score of UC patients with endoscopic score of Mayo 0 and with Mayo 1 was 576.1±437.3 and 1172.7±668.6, respectively. A significant difference of i-scan TE-c score was observed between UC patients with endoscopic score of Mayo 0 and those with Mayo 1 (p,0.001). There was a considerable variation in i-scan TE-c score of UC patients with endoscopic score of Mayo 1 by WL colonoscopy, suggesting that UC patients diagnosed with endoscopic score of Mayo 1 had intestinal inflammation with objectively varying degrees. Conclusion: In UC patients with endoscopic score of Mayo 0 or 1, this new imaging system with i-scan TE-c can make the inflammatory lesion visualized more clearly in comparison with WL colonoscopy, and their intensity and width digitized. Application with this new system is easy and useful for objective and quantitative evaluation of colonic inflammation in UC patients with endoscopic score of Mayo 0 or 1. Further clinical trial with a new imaging system will be required for clinically quiescent UC patients.