Computer-Aided Detection Colonoscopy for Surveillance in IBD Patients: Insights from a Single-Center Experience.

Objectives: The real-world efficacy of computer-aided detection (CADe) in improving surveillance colonoscopy performance for patients with inflammatory bowel disease (IBD) has not been established.

Methods: A retrospective, single-center study of surveillance colonoscopies in patients with IBD. Only colonoscopies indicated for surveillance, with adequate preparation and documented cecal intubation, were included.

Results of the 9th Scientific Workshop of the European Crohn's and Colitis Organisation (ECCO): Artificial Intelligence in Endoscopy, Radiology and Histology in IBD Diagnostics.

In this review, a comprehensive overview of the current state of artificial intelligence (AI) research in Inflammatory Bowel Disease (IBD) diagnostics in the domains of endoscopy, radiology and histology is presented. Moreover, key considerations for development of AI algorithms in medical image analysis are discussed. AI presents a potential breakthrough in real-time, objective and rapid endoscopic assessment, with implications for predicting disease progression.

Results of the 9th Scientific Workshop of the European Crohn's and Colitis Organisation (ECCO): Artificial Intelligence in medical management and precision medicine.

Background And Aims: Artificial intelligence (AI) is increasingly being applied in various fields of medicine, including Inflammatory Bowel Diseases (IBD). This systematic review, conducted as part of the ECCO 9th Scientific Workshop on AI in IBD, explores AI applications in multiomic precision medicine, large language models (LLMs) for textual tasks and utilisation of wearable and remote care technologies.

Methods: A comprehensive systematic analysis of the literature was undertaken, emphasising three topics: multiomic predictive models in IBD; natural language processing (NLP) and LLMs for clinical practice, research and patient communication; and the role of remote monitoring and wearable devices.

Results of the 9th Scientific Workshop of the European Crohn's and Colitis Organisation (ECCO): Artificial Intelligence in IBD: Regulatory and Methodological Considerations.

With the rapid growth of artificial intelligence (AI) applications in the field of inflammatory bowel disease (IBD), an increasing number of regulatory and methodological considerations have become apparent. Currently, there remains much uncertainty and limited experience in the field of IBD regarding some of the regulatory and methodological pitfalls to be considered when developing and deploying AI applications for positive clinical and health system impact. Accordingly, an expert panel was convened by the European Crohn's and Colitis Organisation (ECCO) to review the published literature and provide an overview of key regulatory aspects for the application of AI in IBD.

Results of the Ninth Scientific Workshop of the European Crohn's and Colitis Organisation (ECCO): Artificial intelligence in IBD surgery: opportunities and limitations.

In this narrative review we present the current status of developments in artificial intelligence in the filed of IBD surgery. We lay down the foundations for how IBD surgery may utilise the potential opportunities in utilizing the rapid advances in AI technology as it used in other surgical disciplines. The main areas of potential utility are in the areas of surgical training, risk prediction in the pre, intra and post operative period in IBD patients undergoing surgery and in IBD surgical research.

Elderly-Onset Inflammatory Bowel Disease Has Distinct Disease Characteristics and Treatment Patterns.

Background And Aims: Elderly-onset inflammatory bowel disease (IBD) patients (age ≥ 60 at diagnosis) have unique characteristics that require special consideration. Using a real-life registry-based cohort, we compared disease phenotypes and treatment exposures between adult-onset (18 ≤ age < 60 years) and elderly-onset IBD patients.

Methods: Demographics, disease characteristics, and treatment were compared between adult- and elderly-onset IBD patients diagnosed during 2000-2022 with ≥ 12 months follow-up.

ECCO-ESGAR-ESP-IBUS Guideline on Diagnostics and Monitoring of Patients with Inflammatory Bowel Disease: Part 1.

The current consensus guideline offers a comprehensive and practical guidance on the diagnostic and monitoring of patients with inflammatory bowel disease (IBD). It provides recommendations on requirements for initial diagnosis, detection of complications, the use of monitoring tools in patients with IBD and diagnostics in specific situations, such as pregnancy, postoperatively and for cancer surveillance. The guideline is a joint project of the European Crohn's and Colitis Organization (ECCO), the European Society of Gastrointestinal and Abdominal Radiology, the European Society of Pathology, and the International Bowel Ultrasonography Group under the leadership of ECCO.

Fecal and Serum Metabolome in Crohn's Disease is Linked With Future Flare.

Background: Metabolites are key mediators of various physiological functions. However, there is a lack of data linking their levels to future Crohn's Disease (CD) flares.

Objective: We aimed to identify systemic and gut metabolic changes that precede flare and generate metabolite-based indexes that predict flare using a test cohort, with validation using an independent cohort.

Intestinal ultrasound measurement of bowel wall thickness can be used as a sole marker for defining anti-TNF maintenance therapy failure in Crohn's disease.

Introduction: Bowel wall thickness (BWT) measurements in intestinal ultrasound (IUS) are recognized indicators of inflammatory activity in Crohn's disease (CD). However, the added value of other ultrasonographic parameters for monitoring and predicting treatment failure during anti-tumor necrosis factors' (TNF) maintenance therapy is still not absolutely defined.

Objectives: To determine whether BWT, as measured by IUS, can serve as a reliable single marker for predicting treatment failure in CD patients under anti-TNF therapy, compared to a combination of ultrasonographic parameters.

The effectiveness of second- and-third-line biologics in perianal Crohn's disease-a multicenter propensity score-matched study.

Background And Aims: Anti-tumor necrosis factor-α inhibitors (anti-TNFs) are the established treatment for perianal Crohn's disease (pCD), but relapse and non-response are common. Data on second- and third-line biologics are limited. We present the first direct comparison of second- and third-line biologics in pCD patients with active perianal disease previously treated with first-line anti-TNFs.

Evaluation of the cecal withdrawal vocal timer in screening colonoscopies for optimizing withdrawal time and adenoma detection rate.

Background: Longer cecal withdrawal time has been linked to a higher adenoma detection rate (ADR), with a minimum duration of 6 min recommended. Therefore, we developed the cecal withdrawal vocal timer (CWVT), a novel software tool that is command-activated at cecal intubation and vocally informs the endoscopist of the withdrawal duration every minute.

Objectives: Evaluating the efficacy of the CWVT in enhancing adenoma detection.

Efficacy of digital health technologies in the management of inflammatory bowel disease: an umbrella review.

The use of digital health technology (DHT) is increasing worldwide. Clinical trials assessing available health tools for the management of patients with inflammatory bowel disease (IBD) are sparse, with limited evidence-based outcome data. In this umbrella review, we investigated the effectiveness of DHT in the care of patients with IBD and identified areas for future research following the Joanna Briggs Institute methodology.

The Visibility and Performance of Small Bowel Video Capsule Endoscopy With and Without Pre-Procedural Purge Preparation in the Same Patients.

Background: Small bowel (SB) video capsule endoscopy (VCE) is an established diagnostic tool for the investigation of SB pathologies. Despite clinical studies and a few meta-analyses, an area of continuing controversy is the role of pre-procedural bowel preparation.

Objectives: We compared the visibility and performance of VCE with and without purge preparation in the same patients.

Enhancing diagnostics: ChatGPT-4 performance in ulcerative colitis endoscopic assessment.

Background And Study Aims: The Mayo Endoscopic Subscore (MES) is widely utilized for assessing mucosal activity in ulcerative colitis (UC). Artificial intelligence has emerged as a promising tool for enhancing diagnostic precision and addressing interobserver variability. This study evaluated the diagnostic accuracy of ChatGPT-4, a multimodal large language model, in identifying and grading endoscopic images of UC patients using the MES.

Capsule Endoscopy-Guided Proactive Treat-to-Target Versus Continued Standard Care in Patients With Quiescent Crohn's Disease: A Randomized Controlled Trial.

Background & Aims: Optimal treat-to-target strategies for Crohn's disease (CD) are still being sought. The value of video capsule endoscopy (VCE) to guide proactive treat-to-target optimization in CD was examined.

Methods: A randomized controlled trial of patients with small bowel-involved (L1/L3) CD in corticosteroid-free clinical remission (Crohn's Disease Activity Index < 150).

Inter-Rater Disagreements in Applying the Montreal Classification for Crohn's Disease: The Five-Nations Survey Study.

Background: The Montreal classification has been widely used in Crohn's disease since 2005 to categorize patients by the age of onset (A), disease location (L), behavior (B), and upper gastrointestinal tract and perianal involvement. With evolving management paradigms in Crohn's disease, we aimed to assess the performance of gastroenterologists in applying the Montreal classification.

Methods: An online survey was conducted among participants at an international educational conference on inflammatory bowel diseases.

Intestinal Ultrasound Measures are Strongly Correlated With Small Bowel Endoscopic Lewis Score in Active Crohn's Disease.

Background: Small bowel video capsule endoscopy (SB-VCE) assesses mucosal inflammation in Crohn's disease (CD), while intestinal ultrasound (IUS) examines transmural involvement. We aimed to correlate SB-VCE with IUS in evaluating active CD and monitoring treatment response over time.

Methods: Patients with active SB-CD who initiated biologics were prospectively followed with fecal calprotectin (FC), SB-VCE, and IUS at baseline and after 14 and 52 weeks.

Short-term effectiveness and safety of ustekinumab and vedolizumab in elderly and non-elderly patients with Crohn's disease: a comparative study.

Background: Inflammatory bowel disease (IBD) presents unique challenges in elderly patients due to comorbidities and treatment-related risks.

Objectives: This study evaluates ustekinumab (UST) and vedolizumab (VDZ) efficacy and safety in elderly Crohn's disease (CD) patients.

Design: A retrospective cohort study at a tertiary medical center.

Intestinal ultrasound accurately predicts future therapy failure in Crohn's disease patients in a biologics-induced remission.

Background: Intestinal ultrasound (IUS) is used to assess disease activity, complications, and treatment follow-up in Crohn's disease (CD). Less is known about the association of disease activity on IUS with the risk of future disease relapse during biologically sustained clinical remission in CD.

Aim: The study aimed to investigate the association between IUS activity parameters and subsequent therapy failure in asymptomatic biologically treated patients with CD.

Capsule Endoscopy in Inflammatory Bowel Disease: Evolving Role and Recent Advances.

Capsule endoscopy has been proven as an efficient and accurate tool in the diagnosing and monitoring patients with inflammatory bowel disease, especially Crohn's disease (CD). The current European Crohn's and Colitis Organization guidelines recommend small bowel disease assessment in newly diagnosed CD, wherein small bowel capsule endoscopy (SBCE) is of prime importance. SBCE plays an essential role in assessing mucosal healing in patients with CD, serving as a monitoring tool in a treat to target strategy, and is capable of identifying high-risk patients for future flares.

Bowel cleansing quality evaluation in colon capsule endoscopy: what is the reference standard?

Background: The diagnostic accuracy of colon capsule endoscopy (CCE) depends on a well-cleansed bowel. Evaluating the cleansing quality can be difficult with a substantial interobserver variation.

Objectives: Our primary aim was to establish a standard of agreement for bowel cleansing in CCE based on evaluations by expert readers.

Deployment of an Artificial Intelligence Histology Tool to Aid Qualitative Assessment of Histopathology Using the Nancy Histopathology Index in Ulcerative Colitis.

Background: Ulcerative colitis (UC) is a chronic inflammatory bowel disease characterized by increased stool frequency, rectal bleeding, and urgency. To streamline the quantitative assessment of histopathology using the Nancy Index in UC patients, we developed a novel artificial intelligence (AI) tool based on deep learning and tested it in a proof-of-concept trial. In this study, we report the performance of a modified version of the AI tool.