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PICaSSO validated in real-life study

Presented by
Dr M. Iacucci, University of Birmingham, Birmingham, United Kingdom
ECCO 2020
In a validation study, PICaSSO (Paddington International Virtual ChromoendoScopy ScOre) accurately predicted histological healing and long-term remission and can be a useful tool in the management of ulcerative colitis (UC) [1].

The newly published PICaSSO characterises subtle mucosal and vascular changes and defines mucosal healing, which has become an important goal in UC treatment. In a real-life study, PICaSSO was validated and its ability to predict relapse assessed. A total of 278 patients with UC were prospectively recruited from 11 international centres. Participating endoscopists received training on PICaSSO. For histological assessment, Robarts (RHI) and Nancy histological indexes (NI) were used.

The diagnostic performance of PICaSSO in predicting histological healing is shown in the Table. A PICaSSO of ≤3 for mucosal and vascular architecture resulted in a fair to good prediction of healing, both by RHI and NHI. A total PICaSSO of ≤8 and an Ulcerative Colitis Endoscopic Index of Severity (UCEIS) score of ≤1 also predicted remission after 1 year. A Kaplan–Meier curve showed a favourable chance of survival without relapse with a PICaSSO of ≤8.

Table. Sensitivity, specificity, and accuracy in predicting histological healing [1]

RHI, Robarts histological indexes; NI, Nancy histological indexes; UCEIS, Ulcerative Colitis Endoscopic Index of Severity

    1. Iacucci M, et al. ECCO-IBD 2020, OP26.

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