4.5 Review

Present and future of endoscopy precision for inflammatory bowel disease

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Article Gastroenterology & Hepatology

Usefulness of texture and color enhancement imaging in assessing mucosal healing in patients with ulcerative colitis

Yukie Hayashi et al.

Summary: This study aimed to evaluate the usefulness of texture and color enhancement imaging (TXI) in assessing the degree of inflammation in patients with ulcerative colitis (UC). The results showed that patients with a TXI score of 2 had significantly lower UC relapse rates compared to those with TXI scores of 0-1. TXI score was significantly associated with pathologic scores, and a TXI score of 2 was identified as the only risk factor for UC relapse. Therefore, TXI can be used to identify patients with poor prognosis in MES 1 and provide evidence for controversial treatment intensification.

GASTROINTESTINAL ENDOSCOPY (2023)

Article Gastroenterology & Hepatology

ECCO Guidelines on Inflammatory Bowel Disease and Malignancies

Hannah Gordon et al.

JOURNAL OF CROHNS & COLITIS (2023)

Article Gastroenterology & Hepatology

Intestinal Barrier Healing Is Superior to Endoscopic and Histologic Remission for Predicting Major Adverse Outcomes in Inflammatory Bowel Disease: The Prospective ERIca Trial

Timo Rath et al.

Summary: In this study, the predictive value of endoscopic and histologic remission for long-term disease behavior in patients with inflammatory bowel diseases (IBD) was compared. The results showed that barrier healing was superior to endoscopic and histologic remission in predicting long-term disease progression. Therefore, barrier healing may be considered as a potential treatment target in future clinical trials.

GASTROENTEROLOGY (2023)

Article Gastroenterology & Hepatology

Endocytoscopy for assessing histologic inflammation in ulcerative colitis: development and prospective validation of the ELECT (ErLangen Endocytoscopy in ColiTis) score (with videos)

Francesco Vitali et al.

Summary: This study aimed to evaluate the use of endocytoscopy (EC) to accurately assess histologic inflammation and predict disease progression in ulcerative colitis (UC) patients. The results showed that EC assessment of inflammatory activity in UC was strongly correlated with histopathologic scoring and superior to white-light endoscopy. Therefore, EC can provide real-time histology in UC patients and better predict clinical outcomes.

GASTROINTESTINAL ENDOSCOPY (2023)

Review Gastroenterology & Hepatology

Artificial Intelligence in Inflammatory Bowel Disease Endoscopy: Implications for Clinical Trials

Harris A. Ahmad et al.

Summary: Artificial intelligence has the potential to improve clinical research in inflammatory bowel disease endoscopy. It can enhance the efficiency and accuracy of assessing endoscopic activity in patients with inflammatory bowel disease and the impact of therapeutic interventions. This review discusses the current state of endoscopic assessment in inflammatory bowel disease clinical trials, highlighting the potential for artificial intelligence to transform the current paradigm and suggesting steps for implementation. By incorporating artificial intelligence into quality evaluation and patient progress monitoring, precision endoscopy and clinical trial recruitment in inflammatory bowel disease can be advanced.

JOURNAL OF CROHNS & COLITIS (2023)

Review Oncology

Inflammation-Driven Colorectal Cancer Associated with Colitis: From Pathogenesis to Changing Therapy

Olga Maria Nardone et al.

Summary: Patients with inflammatory bowel disease (IBD) have an increased risk of developing colorectal cancer (CRC) due to chronic intestinal inflammation. Compared to sporadic cases, colitis-associated CRC has unique molecular differences and follows a different sequence of events, primarily inflammation-dysplasia-carcinoma. Recent advancements in understanding the genetic and molecular mechanisms underlying IBD-associated CRC, as well as new OMIC techniques, have opened up possibilities for personalised and organ-sparing therapies. This review provides an overview of the IBD-related carcinogenesis pathway, with a focus on the interaction between microbiota and the gut barrier, and the role of currently available therapies for IBD in the inflammation-dysplasia-cancer sequence.

CANCERS (2023)

Article Gastroenterology & Hepatology

Beyond complete endoscopic healing: Goblet appearance using an endocytoscope to predict future sustained clinical remission in ulcerative colitis

Kazumi Takishima et al.

Summary: This study observed goblet appearance in UC patients with MES = 0 and found that goblet depletion was associated with future clinical relapse.

DIGESTIVE ENDOSCOPY (2022)

Editorial Material Gastroenterology & Hepatology

SCENIC update 2021: Is chromoendoscopy still standard of care for inflammatory bowel disease surveillance?

Ralf Kiesslich

GASTROINTESTINAL ENDOSCOPY (2022)

Article Gastroenterology & Hepatology

Evaluation in real-time use of artificial intelligence during colonoscopy to predict relapse of ulcerative colitis: a prospective study

Yasuharu Maeda et al.

Summary: This study evaluated the use of real-time artificial intelligence during colonoscopy to predict the risk of clinical relapse in patients with ulcerative colitis (UC) in clinical remission. The results showed that real-time AI can help clinicians make treatment interventions decisions.

GASTROINTESTINAL ENDOSCOPY (2022)

Article Gastroenterology & Hepatology

Reproducibility of the electronic chromoendoscopy PICaSSO score (Paddington International Virtual ChromoendoScopy ScOre) in ulcerative colitis using multiple endoscopic platforms: a prospective multicenter international study (with video)

Rosanna Cannatelli et al.

Summary: This study evaluated the reproducibility and accuracy of the Paddington International virtual ChromoendoScopy ScOre (PICaSSO) on NBI and LCI/BLI platforms, showing that PICaSSO score can be consistently and accurately reproduced in these platforms. The correlation and accuracy of PICaSSO for predicting HR were higher in the NBI cohort compared to the LCI/BLI cohort.

GASTROINTESTINAL ENDOSCOPY (2022)

Article Gastroenterology & Hepatology

Combined endocytoscopy with pit pattern diagnosis in ulcerative colitis-associated neoplasia: Pilot study

Shin-ei Kudo et al.

Summary: This retrospective study aimed to demonstrate the diagnostic ability of combined endocytoscopy irregularly-formed nuclei with PIT (EC-IN-PIT) diagnosis to identify ulcerative colitis-associated neoplasias (UCAN). The results showed that EC-IN-PIT diagnosis had a significantly higher specificity and accuracy compared with PIT alone, especially in predicting UCAN with Mayo endoscopic score (MES) 0-1.

DIGESTIVE ENDOSCOPY (2022)

Article Gastroenterology & Hepatology

The diagnostic ability to classify neoplasias occurring in inflammatory bowel disease by artificial intelligence and endoscopists: A pilot study

Shumpei Yamamoto et al.

Summary: The diagnostic accuracy of the two classifications of IBDN was higher than that of the experts. Our AI system is valuable enough to contribute to the next generation of clinical practice.

JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY (2022)

Article Gastroenterology & Hepatology

Endoscopic remission assessed with PICaSSO virtual electronic chromendoscopy accurately predicts clinical outcomes in ulcerative colitis

Olga Maria Nardone et al.

Summary: This study investigated the importance of combined endoscopic-histologic remission in predicting clinical outcomes in ulcerative colitis patients. The results showed that at 12 months, there was no significant difference in predicting specified clinical outcomes between endoscopic remission alone and combined endoscopic-histologic remission, but UCEIS combined with histology showed a significant advantage. More studies with specific therapeutic interventions are needed to confirm these findings.

UNITED EUROPEAN GASTROENTEROLOGY JOURNAL (2022)

Article Gastroenterology & Hepatology

Deep neural network for video colonoscopy of ulcerative colitis: a cross-sectional study

Kento Takenaka et al.

Summary: This study adapted a deep neural network system (DNUC) to real-time video colonoscopy for the detection of histological mucosal inflammation in ulcerative colitis patients. The DNUC showed high sensitivity and specificity in predicting histological remission, and its endoscopic scoring was consistent with expert evaluations. The system has the potential to reduce the number of biopsies required and can be applied in various medical situations.

LANCET GASTROENTEROLOGY & HEPATOLOGY (2022)

Article Gastroenterology & Hepatology

Computer-Aided Imaging Analysis of Probe-Based Confocal Laser Endomicroscopy With Molecular Labeling and Gene Expression Identifies Markers of Response to Biological Therapy in IBD Patients: The Endo-Omics Study

Marietta Iacucci et al.

Summary: This study used computerized image analysis to predict response to biologics in inflammatory bowel disease (IBD) and identified genes predictive of anti-tumor necrosis factor (TNF) response. The results showed that higher mucosal binding of the drug target was associated with response to therapy in ulcerative colitis (UC), while no such association was found in Crohn's disease (CD). Additionally, mucosal and microvascular changes detected by probe confocal laser endomicroscopy (pCLE) were associated with response to biologics in IBD.

INFLAMMATORY BOWEL DISEASES (2022)

Article Gastroenterology & Hepatology

Performance measures for colonoscopy in inflammatory bowel disease patients: European Society of Gastrointestinal Endoscopy (ESGE) Quality Improvement Initiative

Evelien Dekker et al.

Summary: The European Society of Gastrointestinal Endoscopy (ESGE) has recommended a set of performance measures for colonoscopy in inflammatory bowel disease (IBD) patients, aiming to provide a tool for quality monitoring and improvement in endoscopy services.

ENDOSCOPY (2022)

Article Gastroenterology & Hepatology

Application of Deep Learning Models to Improve Ulcerative Colitis Endoscopic Disease Activity Scoring Under Multiple Scoring Systems

Michael F. Byrne et al.

Summary: We developed a deep learning model to improve the accuracy and speed of ulcerative colitis detection, as well as predict the severity scores. The model showed strong agreement with expert assessments and provided a fully automated tool for quality assurance and scoring of endoscopic recordings.

JOURNAL OF CROHNS & COLITIS (2022)

Article Gastroenterology & Hepatology

External validation of the Paddington International Virtual Electronic ChromoendoScopy ScOre as a good endoscopic score to define mucosal healing and predict long-term clinical outcomes in ulcerative colitis

Ge Chong Ruan et al.

Summary: This study validated the clinical value of the PicASSO scoring system in ulcerative colitis (UC), which showed strong correlations with other endoscopic and histological scoring systems. The PicASSO score <= 3 had the highest accuracy in assessing histological remission. Furthermore, the PicASSO score might potentially predict a better long-term clinical outcome in UC patients.

JOURNAL OF DIGESTIVE DISEASES (2022)

Review Gastroenterology & Hepatology

New endoscopic tools in inflammatory bowel disease

Olga Maria Nardone et al.

Summary: Endoscopic remission is considered the ultimate long-term goal for treating inflammatory bowel disease. Advances in endoscopic techniques, such as virtual electronic chromoendoscopy, endocytoscope, and confocal laser endomicroscopy, provide more accurate assessments of the intestinal mucosa. Artificial Intelligence (AI) shows promise in revolutionizing IBD diagnosis and management. These new endoscopic tools, combined with AI, offer incredible opportunities for precision medicine in patients with IBD.

UNITED EUROPEAN GASTROENTEROLOGY JOURNAL (2022)

Editorial Material Gastroenterology & Hepatology

Is artificial intelligence a superior diagnostician in ulcerative colitis?

Shuhei Fukunaga et al.

ENDOSCOPY (2021)

Review Gastroenterology & Hepatology

Performance of artificial intelligence in colonoscopy for adenoma and polyp detection: a systematic review and meta-analysis

Cesare Hassan et al.

Summary: The meta-analysis found that incorporating artificial intelligence as an aid for detecting colorectal neoplasia significantly increases the detection rate of colorectal neoplasia, independently of the main adenoma characteristics.

GASTROINTESTINAL ENDOSCOPY (2021)

Review Gastroenterology & Hepatology

High pooled performance of convolutional neural networks in computer-aided diagnosis of GI ulcers and/or hemorrhage on wireless capsule endoscopy images: a systematic review and meta-analysis

Babu P. Mohan et al.

Summary: Meta-analysis of studies evaluating CNN-based CAD for the diagnosis of GI ulcers and/or hemorrhage on WCE showed high-level performance, suggesting that CNN has the potential to become the first choice for machine learning in optimizing WCE image/video reading.

GASTROINTESTINAL ENDOSCOPY (2021)

Editorial Material Gastroenterology & Hepatology

Can artificial intelligence help to detect dysplasia in patients with ulcerative colitis?

Yasuharu Maeda et al.

ENDOSCOPY (2021)

Article Gastroenterology & Hepatology

Central Reading of Ulcerative Colitis Clinical Trial Videos Using Neural Networks

Klaus Gottlieb et al.

Summary: A deep learning algorithm was successfully trained to predict levels of UC severity from full-length endoscopy videos, with excellent agreement metrics compared to human central readers. Prospective data collection from a multinational clinical trial, use of videos instead of still images, and reporting of UCEIS and eMS all contributed to the success of the machine learning algorithm in predicting UC severity.

GASTROENTEROLOGY (2021)

Article Gastroenterology & Hepatology

Fully automated endoscopic disease activity assessment in ulcerative colitis

Heming Yao et al.

Summary: This study aimed to pilot a fully automated video analysis system for grading endoscopic disease in ulcerative colitis (UC). The results showed promising performance in predicting disease severity in high-resolution videos and clinical trial videos, supporting the potential for artificial intelligence to provide accurate endoscopic disease grading in UC.

GASTROINTESTINAL ENDOSCOPY (2021)

Editorial Material Gastroenterology & Hepatology

Deep Neural Network Accurately Predicts Prognosis of Ulcerative Colitis Using Endoscopic Images

Kento Takenaka et al.

GASTROENTEROLOGY (2021)

Article Gastroenterology & Hepatology

Multicentre randomised controlled trial on virtual chromoendoscopy in the detection of neoplasia during colitis surveillance high-definition colonoscopy (the VIRTUOSO trial)

Kesavan Kandiah et al.

Summary: This study compared the performance of HDV and HDWL in detecting neoplasia in patients with IBD undergoing surveillance colonoscopy, finding no significant difference between the two. The majority of neoplasia were detected on targeted biopsy or resection, with quadrantic non-targeted biopsies providing minimal additional benefit.
Article Gastroenterology & Hepatology

An International Multicenter Real-Life Prospective Study of Electronic Chromoendoscopy Score PICaSSO in Ulcerative Colitis

Marietta Iacucci et al.

Summary: In this study, the PICaSSO score showed strong correlation with multiple histological indices and was predictive of clinical outcomes at 6 and 12 months, similar to histology. Therefore, PICaSSO could be a valuable endoscopic tool in the management of UC.

GASTROENTEROLOGY (2021)

Article Gastroenterology & Hepatology

STRIDE-II: An Update on the Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE) Initiative of the International Organization for the Study of IBD (IOIBD): Determining Therapeutic Goals for Treat-to-Target strategies in IBD

Dan Turner et al.

Summary: STRIDE-II presents treatment targets for both adult and pediatric IBD, including long-term and short-term goals. These targets cover aspects such as clinical response, endoscopic healing, quality of life, and growth, providing guidance for improving patient outcomes.

GASTROENTEROLOGY (2021)

Review Gastroenterology & Hepatology

AGA Clinical Practice Update on Endoscopic Surveillance and Management of Colorectal Dysplasia in Inflammatory Bowel Diseases: Expert Review

Sanjay K. Murthy et al.

Summary: Improvements in disease management, endoscopic technology, and quality have significantly transformed the conceptualization and management of inflammatory bowel disease-related dysplasia over the past 20 years. A conceptual model and best practice advice have been proposed for the prevention, detection, and management of colorectal dysplasia in individuals with inflammatory bowel disease. This expert review, commissioned by the American Gastroenterological Association, aims to provide timely guidance on a topic of high clinical importance to its membership.

GASTROENTEROLOGY (2021)

Article Gastroenterology & Hepatology

Ultra-high Magnification Endocytoscopy and Molecular Markers for Defining Endoscopic and Histologic Remission in Ulcerative Colitis - An Exploratory Study to Define Deep Remission

Marietta Iacucci et al.

Summary: The study showed that endocytoscope scoring system can effectively predict histological remission in patients with ulcerative colitis. Soluble markers such as BDNF, MIP-1 alpha, and sVCAM-1 were identified to predict histological remission. RNA sequencing analysis revealed gene expressions and pathways that discriminate healed from nonhealed mucosa.

INFLAMMATORY BOWEL DISEASES (2021)

Review Medicine, General & Internal

Innovative Diagnostic Endoscopy in Inflammatory Bowel Diseases: From High-Definition to Molecular Endoscopy

Christian Bojarski et al.

Summary: High-definition endoscopy is crucial in the initial diagnosis of inflammatory bowel disease (IBD), helping to characterize inflammation and differentiate between ulcerative colitis and Crohn's disease. In addition to videoendoscopy, the use of dyes sprayed via a catheter can improve detection rates of intraepithelial neoplasia. Virtual chromoendoscopy techniques should not be the sole surveillance strategy in IBD, while the results of oral methylene blue formulation show promise in increasing acceptance rates of classic chromoendoscopy.

FRONTIERS IN MEDICINE (2021)

Review Gastroenterology & Hepatology

Artificial intelligence in gastrointestinal endoscopy for inflammatory bowel disease: a systematic review and new horizons

Gian Eugenio Tontini et al.

Summary: AI-assisted endoscopy in the field of IBD is a rapidly growing research area with promising technical results, showing potential to enhance patient management in clinical practice and gastrointestinal endoscopy. Additional confirmation from real-life clinical settings is needed to validate the benefits of AI in assessing UC mucosal activity and CD capsule endoscopy.

THERAPEUTIC ADVANCES IN GASTROENTEROLOGY (2021)

Article Gastroenterology & Hepatology

Chromoendoscopy With Indigo Carmine vs Virtual Chromoendoscopy (iSCAN1) for Neoplasia Screening in Patients With Inflammatory Bowel Disease: A Prospective Randomized Study

Oscar Gonzalez-Bernardo et al.

Summary: This study found no significant difference in the detection rate of neoplastic lesions between CE and VC in IBD patients, but the examination time with VC was significantly shorter than with CE.

INFLAMMATORY BOWEL DISEASES (2021)

Review Gastroenterology & Hepatology

ECCO Topical Review Optimising Reporting in Surgery, Endoscopy, and Histopathology Collaboration Between S-ECCO, EduCom, H-ECCO

Michel Adamina et al.

Summary: This study highlights the importance of a multidisciplinary approach in the diagnosis and management of inflammatory bowel diseases (IBD), and the need for optimised reporting in endoscopy, surgery, and histopathology. A consensus expert panel conducted a systematic literature review, establishing practice positions and defining standard terminology and reporting framework.

JOURNAL OF CROHNS & COLITIS (2021)

Editorial Material Gastroenterology & Hepatology

Use of Endocytoscopy for Ulcerative Colitis Surveillance: A Case Study Ulcerative Colitis-Associated Colorectal Cancer

Shuhei Fukunaga et al.

GASTROENTEROLOGY (2020)

Article Gastroenterology & Hepatology

Colorectal cancer in Crohn's disease: a Scandinavian population-based cohort study

Ola Olen et al.

LANCET GASTROENTEROLOGY & HEPATOLOGY (2020)

Article Gastroenterology & Hepatology

High-Definition Chromoendoscopy Superior to High-Definition White-Light Endoscopy in Surveillance of Inflammatory Bowel Diseases in a Randomized Trial

Bjarki Alexandersson et al.

CLINICAL GASTROENTEROLOGY AND HEPATOLOGY (2020)

Article Gastroenterology & Hepatology

Assessment of Endoscopic Healing by Using Advanced Technologies Reflects Histological Healing in Ulcerative Colitis

Marietta Iacucci et al.

JOURNAL OF CROHNS & COLITIS (2020)

Article Gastroenterology & Hepatology

Novel computer-assisted diagnosis system for endoscopic disease activity in patients with ulcerative colitis

Tsuyoshi Ozawa et al.

GASTROINTESTINAL ENDOSCOPY (2019)

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Endoscopic detection and resection of dysplasia in inflammatory bowel disease-techniques with videos

Sameen Khalid et al.

INTERNATIONAL JOURNAL OF COLORECTAL DISEASE (2019)

Review Gastroenterology & Hepatology

Systematic review with network meta-analysis: endoscopic techniques for dysplasia surveillance in inflammatory bowel disease

Andrea Iannone et al.

ALIMENTARY PHARMACOLOGY & THERAPEUTICS (2019)

Review Gastroenterology & Hepatology

Can advanced endoscopic techniques for assessment of mucosal inflammation and healing approximate histology in inflammatory bowel disease?

Olga Maria Nardone et al.

THERAPEUTIC ADVANCES IN GASTROENTEROLOGY (2019)

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Endocytoscopic classification can be predictive for relapse in ulcerative colitis

Naoki Ueda et al.

MEDICINE (2018)

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Narrow band imaging efficiency in evaluation of mucosal healing/relapse of ulcerative colitis

Seiko Sasanuma et al.

ENDOSCOPY INTERNATIONAL OPEN (2018)

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Endocytoscopy can be used to assess histological healing in ulcerative colitis

Yoshihiro Nakazato et al.

ENDOSCOPY (2017)

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Molecular imaging of mucosal α4β7 integrin expression with the fluorescent anti-adhesion antibody vedolizumab in Crohn's disease

Timo Rath et al.

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Usefulness of confocal laser endomicroscopy to diagnose ulcerative colitis-associated neoplasia

Naoki Ohmiya et al.

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Confocal laser endomicroscopy: a novel method for prediction of relapse in Crohn's disease

John Gasdal Karstensen et al.

ENDOSCOPY (2016)

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Protective association of colonoscopy against proximal and distal colon cancer and patterns in interval cancer

Amandeep K. Shergill et al.

GASTROINTESTINAL ENDOSCOPY (2015)

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Clinical usefulness of endocytoscopy in the remission stage of ulcerative colitis: a pilot study

Soki Nishiyama et al.

JOURNAL OF GASTROENTEROLOGY (2015)

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Confocal laser endomicroscopy: A new gold standard for the assessment of mucosal healing in ulcerative colitis

Vincent Mace et al.

JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY (2015)

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Silvio Danese et al.

NATURE REVIEWS GASTROENTEROLOGY & HEPATOLOGY (2015)

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Endocytoscopic narrow-band imaging efficiency for evaluation of inflammatory activity in ulcerative colitis

Yasuharu Maeda et al.

WORLD JOURNAL OF GASTROENTEROLOGY (2015)

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Use of confocal laser endomicroscopy to predict relapse of ulcerative colitis

Chang-Qing Li et al.

BMC GASTROENTEROLOGY (2014)

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Confocal laser endomicroscopy for prediction of disease relapse in ulcerative colitis: A pilot study

Andrea Buda et al.

JOURNAL OF CROHNS & COLITIS (2014)

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The Detection of Nonpolypoid (Flat and Depressed) Colorectal Neoplasms in Patients With Inflammatory Bowel Disease

Roy Soetikno et al.

GASTROENTEROLOGY (2013)

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702 Development of a New Classification for Confocal LASER Endomicroscopy in IBD

Helmut Neumann et al.

GASTROINTESTINAL ENDOSCOPY (2013)

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Classification of Inflammation Activity in Ulcerative Colitis by Confocal Laser Endomicroscopy

Chang-Qing Li et al.

AMERICAN JOURNAL OF GASTROENTEROLOGY (2010)

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AGA Technical Review on the Diagnosis and Management of Colorectal Neoplasia in Inflammatory Bowel Disease

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Narrow-band imaging endoscopy to assess mucosal angiogenesis in inflammatory bowel disease: A pilot study

Silvio Danese et al.

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Real-time in vivo virtual histology of colorectal lesions when using the endocytoscopy system

Keita Sasajima et al.

GASTROINTESTINAL ENDOSCOPY (2006)

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Most dysplasia in ulcerative colitis is visible at colonoscopy

MD Rutter et al.

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