Narrow Band Endoscopy Assessment of Ulcerative Colitis Activity and its Correlation with Histopathology

Gawish, Ahmed Ebrahim; Eliwa, Ahmed Maher; Mabrouk, Shadia Hussein; Ebrahim, Atef Aboelfotoh

doi:10.21608/aimj.2025.446455

Narrow Band Endoscopy Assessment of Ulcerative Colitis Activity and its Correlation with Histopathology

Document Type : Original Article

Authors

¹ Gastroenterology and Hepatology Unit, Department of Internal Medicine, Faculty of Medicine for Boys, Al-Azhar University, Cairo, Egypt

² Pathology, Faculty of Medicine, Ain Shams University Cairo, Egypt

10.21608/aimj.2025.446455

Abstract

Background: Several grading schemes were established to accurately assess histopathological and endoscopic recovery in ulcerative colitis patients. A new virtual electronic chromoendoscopy score, known as the Paddington International Virtual Chromoendoscopy Score, was created to assess vascular and mucosal architecture.
Aim: To evaluate the accuracy of virtual chromo endoscopy in recognition of UC activity and compare its results with those of the histopathological examination.
Methodology: Fifty patients diagnosed with UC participated in this prospective study. For endoscopic evaluation, the Mayo Endoscopic Score, UC Endoscopic Index of Severity, and PICaSSO were used. Picasso Histologic Remission Index (PHRI), Nancy Histological Index (NHI), and Robarts Histological Index (RHI) were used to grade each biopsy sample.
Results: We found a high association between PICaSSO and the histological and endoscopic rating methods. When evaluating histological remission (HR), PICaSSO ≤3 Demonstrated advantages, with the maximum accuracy of 98% for NHI, 94% for PHRI, and 90% for RHI. PICaSSO and histology scores (RHI, PHRI, and NHI) have a strong association, with correlation coefficients that are noticeably higher than those of the MES and the UCEIS as defined by RHI ≤3 (AUROC 0.76, 95% CI 0.53 to 1.00), PHRI (< 1 (AUROC 0.83, 95% CI 0.64 to 1.00), and NHI ≤1 (AUROC 0.99, 95% CI 0.96 to 1.00). HH was recognized with a PICaSSO score of ≤3.
Conclusions: PICaSSO showed strong correlations with other ulcerative colitis scoring systems, including endoscopic and histological methods.

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