Endoscopic and histological remission (HR) are key therapeutic targets in the management of ulcerative colitis (UC). The aim of this study was to evaluate the reproducibility of PICaSSO (Paddington International virtual ChromoendoScopy ScOre), a virtual chromoendoscopy score originally validated using the iSCAN platform, with the NBI (Narrow Band Imaging), LCI (linked color Imaging) and BLI (Blu Laser Imaging) platforms.
We evaluated endoscopic activity using Mayo Endoscopic Score (MES), Ulcerative Colitis Endoscopic Index of Severity (UCEIS) and PICaSSO in 159 UC patients (78 NBI and 81 BLI/LCI) who underwent colonoscopy in two tertiary referral centers. HR was defined by Robarts Histology Index (RHI) and Nancy Index (NHI). ROC curves were plotted to evaluate endoscopic scores for the prediction of HR. Intraclass correlation coefficient (ICC) between endoscopists was evaluated.
PICaSSO had an ICC of 0.825 when combining both NBI and BLI/LCI cohorts, higher than MES and UCEIS. The correlation between PICaSSO and RHI and NHI was 0.83 and 0.79 in the NBI cohort and between 0.63-0.65 in LCI/BLI. In the NBI cohort, the accuracy of MES, UCEIS and PICaSSO was 0.936, 0.897 and 0.808 for HR measured by RHI and 0.897, 0.885 and 0.821 by NHI, respectively. In the BLI/LCI cohort, the accuracy of MES, UCEIS, LCI PICaSSO and BLI PICaSSO were 0.765, 0.778, 0.827 and 0.79 to predict HR with RHI and NHI, respectively.
PICaSSO score can be consistently and accurately reproduced with NBI and LCI/BLI, and therefore can be applied to all VCE platforms.

Copyright © 2022 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

Author