TY - JOUR
T1 - An International Multicenter Real-Life Prospective Study of Electronic Chromoendoscopy Score PICaSSO in Ulcerative Colitis
AU - Iacucci, Marietta
AU - Smith, Samuel C.L.
AU - Bazarova, Alina
AU - Shivaji, Uday N.
AU - Bhandari, Pradeep
AU - Cannatelli, Rosanna
AU - Daperno, Marco
AU - Ferraz, Jose
AU - Goetz, Martin
AU - Gui, Xianyong
AU - Hayee, Bu
AU - De Hertogh, Gert
AU - Lazarev, Mark
AU - Li, Jim
AU - Nardone, Olga M.
AU - Parra-Blanco, Adolfo
AU - Pastorelli, Luca
AU - Panaccione, Remo
AU - Occhipinti, Vincenzo
AU - Rath, Timo
AU - Tontini, Gian Eugenio
AU - Vieth, Michael
AU - Villanacci, Vincenzo
AU - Zardo, Davide
AU - Bisschops, Raf
AU - Kiesslich, Ralf
AU - Ghosh, Subrata
N1 - Funding Information:
Funding Marietta Iacucci and Subrata Ghosh are part-funded by the NIHR Birmingham Biomedical Research Centre. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health.
Publisher Copyright:
© 2021 AGA Institute
PY - 2021/4
Y1 - 2021/4
N2 - Background & Aims: Endoscopic and histologic remission are important goals in the treatment of ulcerative colitis (UC). We investigated the correlation of the recently developed Paddington International Virtual ChromoendoScopy ScOre (PICaSSO) and other established endoscopic scores against multiple histological indices and prospectively assessed outcomes. Methods: In this prospective multicenter international study, inflammatory activity was assessed with high-definition and virtual chromoendoscopy in the rectum and sigmoid using the Mayo Endoscopic Score (MES), UC Endoscopic Index of Severity (UCEIS), and PICaSSO. Targeted biopsies were taken for assessment using Robarts Histological Index (RHI), Nancy Histological index (NHI), ECAP (Extent, Chronicity, Activity, Plus score), Geboes, and Villanacci. Follow-up data were obtained at 6 and 12 months after colonoscopy. Results: A total of 307 patients were recruited. There was strong correlation between PICaSSO and histology scores, significantly superior to correlation coefficients of MES and UCEIS with histology scores. A PICaSSO score of ≤3 detected histologic remission by RHI (≤3 + absence of neutrophils) with area under the receiver operating characteristic curve (AUROC) 0.90 (95% confidence interval [CI] 0.86–0.94) and NHI (≤1) AUROC 0.82 (95% CI 0.77–0.87). The interobserver agreement for PICaSSO was 0.88 (95% CI 0.83–0.92). At 6- and 12-months follow-up, PICaSSO score ≤3 predicted better outcomes than PICaSSO >3 (hazard ratio [HR] 0.19 [0.11–0.33] and 0.22 [0.13–0.34], respectively),} as well as PICaSSO 4–8 (HR 0.25 [0.12–0.53] and 0.22 (0.12–0.39), respectively) and similar to histologic remission. Conclusion: In this first real-life multicenter study, the PICaSSO score correlated strongly with multiple histological indices. Furthermore, PICaSSO score predicted specified clinical outcomes at 6 and 12 months, similar to histology. Thus, PICaSSO can be a useful endoscopic tool in the therapeutic management of UC.
AB - Background & Aims: Endoscopic and histologic remission are important goals in the treatment of ulcerative colitis (UC). We investigated the correlation of the recently developed Paddington International Virtual ChromoendoScopy ScOre (PICaSSO) and other established endoscopic scores against multiple histological indices and prospectively assessed outcomes. Methods: In this prospective multicenter international study, inflammatory activity was assessed with high-definition and virtual chromoendoscopy in the rectum and sigmoid using the Mayo Endoscopic Score (MES), UC Endoscopic Index of Severity (UCEIS), and PICaSSO. Targeted biopsies were taken for assessment using Robarts Histological Index (RHI), Nancy Histological index (NHI), ECAP (Extent, Chronicity, Activity, Plus score), Geboes, and Villanacci. Follow-up data were obtained at 6 and 12 months after colonoscopy. Results: A total of 307 patients were recruited. There was strong correlation between PICaSSO and histology scores, significantly superior to correlation coefficients of MES and UCEIS with histology scores. A PICaSSO score of ≤3 detected histologic remission by RHI (≤3 + absence of neutrophils) with area under the receiver operating characteristic curve (AUROC) 0.90 (95% confidence interval [CI] 0.86–0.94) and NHI (≤1) AUROC 0.82 (95% CI 0.77–0.87). The interobserver agreement for PICaSSO was 0.88 (95% CI 0.83–0.92). At 6- and 12-months follow-up, PICaSSO score ≤3 predicted better outcomes than PICaSSO >3 (hazard ratio [HR] 0.19 [0.11–0.33] and 0.22 [0.13–0.34], respectively),} as well as PICaSSO 4–8 (HR 0.25 [0.12–0.53] and 0.22 (0.12–0.39), respectively) and similar to histologic remission. Conclusion: In this first real-life multicenter study, the PICaSSO score correlated strongly with multiple histological indices. Furthermore, PICaSSO score predicted specified clinical outcomes at 6 and 12 months, similar to histology. Thus, PICaSSO can be a useful endoscopic tool in the therapeutic management of UC.
KW - Endoscopic Remission
KW - Histological Remission
KW - Mucosal Healing
KW - Ulcerative Colitis
KW - Virtual Electronic Chromoendoscopy
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UR - http://www.scopus.com/inward/citedby.url?scp=85103705928&partnerID=8YFLogxK
U2 - 10.1053/j.gastro.2020.12.024
DO - 10.1053/j.gastro.2020.12.024
M3 - Article
C2 - 33347880
AN - SCOPUS:85103705928
SN - 0016-5085
VL - 160
SP - 1558-1569.e8
JO - Gastroenterology
JF - Gastroenterology
IS - 5
ER -