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COLONIC EPITHELIAL BRUSH BORDER ALTERATIONS IN MICROSCOPIC COLITIS: AN INTEGRATED MULTI-OMIC ANALYSIS

Danila Guagnozzi 1,2,3, Ana Maria González 2, Fernando Fernández-Bañares 4,5, Andreas Münch 6, Yamile Zabana 4,5, Eva Tristan 4, Juanjo Lozano 7, Julia Sidorova 7, Beatriz Lobo Alvarez 8,2, Carmen Alonso-Cotoner 1,2,3, Elba Expósito 2, Alfredo J. Lucendo 9,10, Mercé Albert-Bayo 2,11, Stefania Landolfi 1, marc pigrau 1, Ana Benages 1, Ronald Llerena Castro 2, Joan Dot 1, Javier Santos 1,2,3, Maria Vicario 12,2

Affiliations

1 University Hospital Vall de Hebron, Barcelona, Spain

2 Vall d’Hebron Institut de Recerca, Barcelona, Spain

3 Centro de investigación Biomédica en Red de Enfermedades Heáticas y Digestivas (CIBERehd), Barcelona, Spain

4 University Hospital Mutua de Terrassa, Terrassa, Spain

5 Centro de investigación Biomédica en Red de Enfermedades Heáticas y Digestivas (CIBERehd), Terrassa, Spain

6 Linköping Hospital, Linköping, Sweden

7 Centro de investigación Biomédica en Red de Enfermedades Heáticas y Digestivas (CIBERehd), Madrid, Spain

8 Vall de Hebron University Hospital, Barcelona, Spain

9 Hospital General de Tomelloso, Tomelloso, Spain

10 Centro de investigación Biomédica en Red de Enfermedades Heáticas y Digestivas (CIBERehd), Tomelloso, Spain

11 Translational Mucosal Immunology laboratory, Barcelona, Spain

12 Société Des Produicts Nestlé S.A., Nestlé Research, Lausanne, Switzerland

Summary

AI Generated

Multi-omic analysis with electron microscopy reveals dysregulated brush border molecular pathways and structural microvilli defects in microscopic colitis, particularly collagenous colitis, compared to healthy controls and IBS-D patients.

RNA-Seq analysis identified three microvilli-related pathways significantly enriched in collagenous colitis compared to lymphocytic colitis, IBS-D, and healthy controls, with integrated analysis revealing 28 genes showing significant RNA-protein expression correlation.
Collagenous colitis showed reduced expression of microvilli proteins and actin-binding proteins compared to all other groups, while both collagenous and lymphocytic colitis showed altered protein expression in the actin-membrane junction.
Electron microscopy demonstrated that microvilli in microscopic colitis were more scattered, irregular, and shorter than in healthy controls and IBS-D, with microvilli density reduced in collagenous colitis (3.7 per μm) and lymphocytic colitis (5.2 per μm) versus healthy controls (7.5 per μm).
Microvilli length was significantly reduced in both collagenous colitis (0.5 μm) and lymphocytic colitis (0.6 μm) compared to healthy controls (1.1 μm), with no differences observed between IBS-D and healthy controls.
This study provides previously undescribed molecular and ultrastructural characterization of brush border dysfunction in microscopic colitis that may inform future pathophysiological understanding and potential diagnostic or therapeutic approaches.

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This summary was generated by an AI large language model based on the content transcript. It is for informational purposes only and should not be considered a substitute for clinical judgment. Always rely on your professional expertise and the full clinical context when making clinical decisions.

Abstract

Introduction

Collagenous colitis (CC) and lymphocytic colitis (LC), the two main subtypes of microscopic colitis (MC), are chronic inflammatory diseases of the colon of unknown etiology. Colonic barrier dysfunction has been identified in patients with MC. However, whether molecular and structural alterations underlie an aberrant barrier in MC remains to be defined.

Aims & Methods

To identify the molecular pathways involved in the colonic epithelial brush border structure and its ultrastructural alterations in MC. Total RNA and protein were obtained from sigmoid mucosal biopsies of healthy controls (Hc) (N=11), patients with active diarrhoea predominant irritable bowel syndrome (IBS-D) patients (N=13), and active newly diagnosed naive of treatment MC patients (N=12 CC and N=12 LC). Transcriptomic and proteomic analyses were performed by RNAseq analysis and liquid chromatography mass spectrometry, respectively. Additionally, in a subset of patients (N=8 CC, N=8 LC, N=8 IBS-D and N=8 Hc) sigmoid biospies were collected and processed for scanning and transmission electron microscopy (SEM and TEM, respectively), to perform a qualitative and quantitative assessment of the colonic epithelium. Integrated data assessment was performed to explore biological and molecular functions.

Results

By RNA-Seq enrichment study, three microvilli-related pathways (organization, regulation of microvilli organization and length) were significantly enriched in the colonic mucosa of CC patients compared to LC, IBS-D and Hc. The integrated multi-omic analysis identified 28 genes with a significant positive correlation between RNA expression and its corresponding protein expression, (4 genes with a strong correlation (r>0.7, p<0.05) and 21 genes with a moderate correlation (0.3<r<0.7, p<0.05)), which were related to each other at the network level by string database analysis. Reduced expression of the microvilli proteins, was observed in CC compared to Hc, IBS-D and LC patients. Reduced expression of the actin-binding proteins, was also observed in CC. Moreover, decreased protein expression and an increased expression of proteins in the actin-membrane junction, were observed in CC and LC. Ultrastructural observation revealed that microvilli on the colonic surface of MC patients were more scattered, irregular and shorter in MC than IBS-D and Hc. Furthermore, the number of microvilli per colonocyte length (microvilli/um) was lower in CC (3.7[2.8-5.3], p<0.0001) and LC patients (5.2[4.0-6.6], p=0.01) compared to Hc (7.5[6.6-8.7]). Similarly, microvilli length was also reduced in CC (0.5[0.4-0.8], p=0.0003) and LC (0.6[0.4-1.1], p=0.04) patients compared to Hc (1.1[1.0-1.4]). No differences in the number and length of microvilli were observed between IBS-D and Hc groups.

Conclusion

Dysregulated brush border molecular pathways underlie epithelial colonic dysfunction in MC compared to Hc and IBS-D patients at both molecular and ultrastructural levels. These previously undescribed data open new perspectives in defining the pathophysiological mechanisms of MC, especially in CC. Given the fundamental role of the brush border in maintaining intestinal homeostasis and even water absorption, further understanding of these mechanisms may have significant diagnostic and therapeutic implications for MC.

Disclosure

Dr Javier Santos has served as consultant for Noventure SL, Devintecpharma, Reckitt, Ipsen, Aboca & Pileje and discloses present and past recent scientific collaborations with Salvat, Norgine, Alfa-Sigma, Cosmo, Adare, Ordesa and Danone that do not constitute a conflict of interest in developing the content of the present manuscript.

Conference

UEG Week Copenhagen 2023

Topics

IBD

Submission format

Abstract

Session

PP 05 IBD (Posters)

Citation

United European Gastroenterology Journal 2023; 11 (Supplement 8)

Published

2023

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Exocrine pancreatic insufficiency: is there a pancreas-liver axis?

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SPRAY COAGULATION REDUCES INTRAPROCEDURAL BLEEDING DURING ENDOSCOPIC SUBMUCOSAL DISSECTION COMPARED TO SWIFT COAGULATION: A PROPENSITY SCORE–MATCHED COHORT STUDY

David James Tate

PEPPERMINT OIL VERSUS URSODEOXYCHOLIC ACID FOR PREVENTING RECURRENT CHOLEDOCHOLITHIASIS AFTER ERCP STONE CLEARANCE: A 2-YEAR PROSPECTIVE RANDOMIZED CONTROLLED TRIAL

Hongzhang Shen

Coeliac disease and gluten-related disorders

Julio Bai

Introduction: Are you stuck in the biliary cannulation nightmare: Wake up, here comes the sun

Andrea Anderloni

ACCURATE AND ROBUST COLLAGENOUS COLITIS DETECTION IN HISTOLOGICAL IMAGES USING FEATURES EXTRACTED FROM SEGMENTED AREAS BASED ON SUPERPIXELS TOGETHER WITH DEEP LEARNING

Rima Ramonaite

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Exocrine pancreatic insufficiency: is there a pancreas-liver axis?

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Exocrine pancreatic insufficiency: is there a pancreas-liver axis?

Ashkar Motaz 1

Affiliations

1 Mayo Clinic, Rochester, United States of America

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Abstract

Event

UEG Week Barcelona 2026

Topics

Endoscopy IBD

Session

Hot topics in European Gastroenterology

Citation

2026: United European Gastroenterology Journal 2026; 14 (S1)

Published

2026

More Like This:

Exocrine pancreatic insufficiency: is there a pancreas-liver axis?

Ashkar Motaz

SPRAY COAGULATION REDUCES INTRAPROCEDURAL BLEEDING DURING ENDOSCOPIC SUBMUCOSAL DISSECTION COMPARED TO SWIFT COAGULATION: A PROPENSITY SCORE–MATCHED COHORT STUDY

David James Tate

PEPPERMINT OIL VERSUS URSODEOXYCHOLIC ACID FOR PREVENTING RECURRENT CHOLEDOCHOLITHIASIS AFTER ERCP STONE CLEARANCE: A 2-YEAR PROSPECTIVE RANDOMIZED CONTROLLED TRIAL

Hongzhang Shen

Coeliac disease and gluten-related disorders

Julio Bai

Introduction: Are you stuck in the biliary cannulation nightmare: Wake up, here comes the sun

Andrea Anderloni

ACCURATE AND ROBUST COLLAGENOUS COLITIS DETECTION IN HISTOLOGICAL IMAGES USING FEATURES EXTRACTED FROM SEGMENTED AREAS BASED ON SUPERPIXELS TOGETHER WITH DEEP LEARNING

Rima Ramonaite

UEG Presentation

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SPRAY COAGULATION REDUCES INTRAPROCEDURAL BLEEDING DURING ENDOSCOPIC SUBMUCOSAL DISSECTION COMPARED TO SWIFT COAGULATION: A PROPENSITY SCORE–MATCHED COHORT STUDY

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SPRAY COAGULATION REDUCES INTRAPROCEDURAL BLEEDING DURING ENDOSCOPIC SUBMUCOSAL DISSECTION COMPARED TO SWIFT COAGULATION: A PROPENSITY SCORE–MATCHED COHORT STUDY

Andrea Sorge 1,2, Michele Montori 2, Maria Eva Argenziano 2, Tamás Tornai 3, Adam Monod 2, Pieter Jan Poortmans 4, Lobke Desomer 5, David James Tate 6

Affiliations

1 University of Padua, Padua, Italy

2 University Hospital Ghent, Ghent, Belgium

3 Semmelweis University, Budapest, Hungary

4 University Hospital Ghent, University Hospital Brussels, Asse, Belgium

5 Az Delta, Drongen, Belgium

6 University Hospital Ghent, Gent, Belgium

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Abstract

Introduction

Intraprocedural bleeding is a source of technical complexity during endoscopic submucosal dissection (ESD) and may require exchange to coagulation forceps. Spray coagulation is a non-contact, high–peak–voltage mode that combines tissue dissection with powerful coagulation. However, evidence supporting its use in ESD is limited to the stomach.

Aims & Methods

We aimed to evaluate whether spray-coagulation ESD (SP-ESD) improves intraprocedural bleeding control compared to swift ESD (SW-ESD). We analyzed consecutive esophageal, gastric, colonic, and rectal ESDs performed at a tertiary referral center over thirty-six months. SP-ESD was compared to SW-ESD. Assessment of complete procedural video was performed with event-level timestamps. SW-ESD procedures were matched 1:2 to SP-ESD procedures by propensity score on prespecified baseline covariates. The primary outcome was intraprocedural bleeding events. Secondary outcomes were total bleeding time, dissection speed, and coagulation forceps use.

Results

Of 147 eligible ESDs, 91 (60 SP-ESD, 31 SW-ESD) were matched. SP-ESD was associated with fewer bleeding events (mean 1.8 vs 4.2 per procedure; count ratio, .43; 95% CI, .26-.70; P = .001), persisting after accounting for dissection time (rate ratio, .51 per minute; 95% CI, .31-.85). Bleeding time was shorter (median .4 vs 5.5 minutes; ratio of means, .40; 95% CI, .22-.73) and dissection faster (median 16.8 vs 11.6 mm²/min; geometric mean ratio, 1.33; 95% CI, 1.03-1.70). Coagulation forceps were applied a mean of .1 versus 2.6 times per procedure, and 95.0% versus 29.0% were forceps-free (RR, 3.27; 95% CI, 1.79-5.99). R0 resection, en bloc resection, perforation, and delayed bleeding did not differ.

TABLE. Primary and secondary outcomes in the propensity score–matched cohort (n = 91)

Outcome	SW-ESD	SP-ESD	Effect (SP-ESD vs SW-ESD, 95% CI)	P value
Intraprocedural bleeds, mean (primary)	4.2	1.8	CR, .43 (.26-.70)	.001
Bleeding time, min, median	5.5	.4	Ratio of means, .40 (.22-.73)	.003
Dissection speed, mm2/min, median	11.6	16.8	GMR, 1.33 (1.03-1.70)	.027

Conclusion

SP-ESD was associated with substantially less intraprocedural bleeding and coagulation forceps use, and faster dissection without cost in resection quality or safety compared to SW-ESD. Spray coagulation mode can be selected as one of the available electrosurgical modalities to improve bleeding control during ESD.

Event

UEG Week Barcelona 2026

Topics

Primary Care Oesophagus Hepatobiliary Endoscopy Digestive Oncology Colorectal

Submission format

Late-Breaking Abstract

Session

Late-Breaking: Advances in GI-endoscopy

Citation

2026: United European Gastroenterology Journal 2026; 14 (S1)

Published

2026

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Exocrine pancreatic insufficiency: is there a pancreas-liver axis?

Ashkar Motaz

SPRAY COAGULATION REDUCES INTRAPROCEDURAL BLEEDING DURING ENDOSCOPIC SUBMUCOSAL DISSECTION COMPARED TO SWIFT COAGULATION: A PROPENSITY SCORE–MATCHED COHORT STUDY

David James Tate

PEPPERMINT OIL VERSUS URSODEOXYCHOLIC ACID FOR PREVENTING RECURRENT CHOLEDOCHOLITHIASIS AFTER ERCP STONE CLEARANCE: A 2-YEAR PROSPECTIVE RANDOMIZED CONTROLLED TRIAL

Hongzhang Shen

Coeliac disease and gluten-related disorders

Julio Bai

Introduction: Are you stuck in the biliary cannulation nightmare: Wake up, here comes the sun

Andrea Anderloni

ACCURATE AND ROBUST COLLAGENOUS COLITIS DETECTION IN HISTOLOGICAL IMAGES USING FEATURES EXTRACTED FROM SEGMENTED AREAS BASED ON SUPERPIXELS TOGETHER WITH DEEP LEARNING

Rima Ramonaite

UEG Presentation

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PEPPERMINT OIL VERSUS URSODEOXYCHOLIC ACID FOR PREVENTING RECURRENT CHOLEDOCHOLITHIASIS AFTER ERCP STONE CLEARANCE: A 2-YEAR PROSPECTIVE RANDOMIZED CONTROLLED TRIAL

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PEPPERMINT OIL VERSUS URSODEOXYCHOLIC ACID FOR PREVENTING RECURRENT CHOLEDOCHOLITHIASIS AFTER ERCP STONE CLEARANCE: A 2-YEAR PROSPECTIVE RANDOMIZED CONTROLLED TRIAL

Haitao Huang 1,2, Yiwen Feng 3, Huanlu Xu 3, Jianlong Chen 3, Liyun Zheng 1, Dongchao Xu 1, Xiaofeng Zhang 1,2, Hangbin Jin 1,2, jing Yang 1,2, Hongzhang Shen 1,2

Affiliations

1 Hangzhou First People's Hospital, Hangzhou, China

2 School of Medicine, Westlake University, Hangzhou, China

3 The Fourth Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China

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Abstract

Introduction

Endoscopic retrograde cholangiopancreatography (ERCP) is the gold standard for common bile duct stones (CBDS) clearance, but stone recurrence remains a significant clinical challenge, affecting 4%–24% of patients. Ursodeoxycholic acid (UDCA) is commonly used for prevention, but its efficacy is controversial, particularly for pigment stones, and its use is often limited by dose-dependent diarrhea. Peppermint oil, a hydrocholeretic agent with calcium-channel blocking properties, may offer an alternative by promoting biliary flushing and relaxing the sphincter of Oddi.

Aims & Methods

This prospective, randomized, open-label, active-controlled trial (NCT04484870) enrolled patients aged 18–80 years with complete CBDS clearance confirmed by ERCP. Participants were randomized (1:1) to receive Peppermint Oil (0.45 g, t.i.d., before meals) or UDCA (10 mg/kg/day, b.i.d.) for 6 months, with a 24-month follow-up. The primary endpoint was CBDS recurrence (defined as stones identified >6 months post-clearance). Recurrence-free survival was analyzed using Kaplan–Meier and Cox proportional hazards models. Outcome assessors were blinded to group allocation (PROBE design).

Results

A total of 211 patients (107 Peppermint Oil, 104 UDCA) were included in the ITT analysis. At 24 months, stone recurrence occurred in 25.2% (27/107) of the Peppermint Oil group and 37.5% (39/104) of the UDCA group (Log-rank P = 0.076). After adjusting for pre-specified variables (age, history of EST, CBD diameter, and periampullary diverticulum), Peppermint Oil showed a consistent trend towards risk reduction (adjusted HR = 0.69, 95% CI 0.41–1.14, P = 0.148). Periampullary diverticulum was identified as an independent risk factor for recurrence (HR = 1.76, 95% CI 1.02–3.03, P = 0.042). Liver function recovery trajectories were comparable between groups (P > 0.05). While overall adverse event rates were similar (13.1% vs. 8.7%, P = 0.417), the UDCA group had a significantly higher incidence of diarrhea (6.7% vs. 0%, P = 0.006). Menthol eructation (7.5%) and mild heartburn (4.7%) were more common with Peppermint Oil.

Conclusion

Peppermint oil (Danshu Capsule) demonstrated a favorable trend towards reducing CBDS recurrence compared to UDCA, although the primary endpoint did not reach statistical significance. Its distinct safety profile, particularly the absence of diarrhea, suggests it is a well-tolerated and promising alternative for long-term prevention, especially in patients who have undergone EST or are intolerant to UDCA.

Event

UEG Week Barcelona 2026

Topics

Radiology & Imaging Hepatobiliary Endoscopy

Submission format

Abstract

Session

Endoscopy: Taming the biliary tree

Citation

2026: United European Gastroenterology Journal 2026; 14 (S1)

Published

2026

More Like This:

Exocrine pancreatic insufficiency: is there a pancreas-liver axis?

Ashkar Motaz

SPRAY COAGULATION REDUCES INTRAPROCEDURAL BLEEDING DURING ENDOSCOPIC SUBMUCOSAL DISSECTION COMPARED TO SWIFT COAGULATION: A PROPENSITY SCORE–MATCHED COHORT STUDY

David James Tate

PEPPERMINT OIL VERSUS URSODEOXYCHOLIC ACID FOR PREVENTING RECURRENT CHOLEDOCHOLITHIASIS AFTER ERCP STONE CLEARANCE: A 2-YEAR PROSPECTIVE RANDOMIZED CONTROLLED TRIAL

Hongzhang Shen

Coeliac disease and gluten-related disorders

Julio Bai

Introduction: Are you stuck in the biliary cannulation nightmare: Wake up, here comes the sun

Andrea Anderloni

ACCURATE AND ROBUST COLLAGENOUS COLITIS DETECTION IN HISTOLOGICAL IMAGES USING FEATURES EXTRACTED FROM SEGMENTED AREAS BASED ON SUPERPIXELS TOGETHER WITH DEEP LEARNING

Rima Ramonaite

UEG Presentation

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Coeliac disease and gluten-related disorders

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Coeliac disease and gluten-related disorders

Julio Bai 1

Affiliations

1 Hospital de Gastroenterología Dr. C. Bonorino Udaondo, Buenos Aires, Argentina

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Abstract

Event

UEG Week Barcelona 2026

Topics

Paediatrics Hepatobiliary Small Intestine & Nutrition Immunology IBD Digestive Oncology

Session

Best of DDW

Citation

2026: United European Gastroenterology Journal 2026; 14 (S1)

Published

2026

More Like This:

Exocrine pancreatic insufficiency: is there a pancreas-liver axis?

Ashkar Motaz

SPRAY COAGULATION REDUCES INTRAPROCEDURAL BLEEDING DURING ENDOSCOPIC SUBMUCOSAL DISSECTION COMPARED TO SWIFT COAGULATION: A PROPENSITY SCORE–MATCHED COHORT STUDY

David James Tate

PEPPERMINT OIL VERSUS URSODEOXYCHOLIC ACID FOR PREVENTING RECURRENT CHOLEDOCHOLITHIASIS AFTER ERCP STONE CLEARANCE: A 2-YEAR PROSPECTIVE RANDOMIZED CONTROLLED TRIAL

Hongzhang Shen

Coeliac disease and gluten-related disorders

Julio Bai

Introduction: Are you stuck in the biliary cannulation nightmare: Wake up, here comes the sun

Andrea Anderloni

ACCURATE AND ROBUST COLLAGENOUS COLITIS DETECTION IN HISTOLOGICAL IMAGES USING FEATURES EXTRACTED FROM SEGMENTED AREAS BASED ON SUPERPIXELS TOGETHER WITH DEEP LEARNING

Rima Ramonaite

UEG Presentation

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Introduction: Are you stuck in the biliary cannulation nightmare: Wake up, here comes the sun

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Introduction: Are you stuck in the biliary cannulation nightmare: Wake up, here comes the sun

Andrea Anderloni 1

Affiliations

1 San Matteo Hospital, Pavia, Italy

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Abstract

Event

Postgraduate Teaching Programme Barcelona 2026

Topics

Hepatobiliary Endoscopy

Session

Are you stuck in the biliary cannulation nightmare: Wake up, here comes the sun

Citation

2026: United European Gastroenterology Journal 2026; 14 (S1)

Published

2026

More Like This:

Exocrine pancreatic insufficiency: is there a pancreas-liver axis?

Ashkar Motaz

SPRAY COAGULATION REDUCES INTRAPROCEDURAL BLEEDING DURING ENDOSCOPIC SUBMUCOSAL DISSECTION COMPARED TO SWIFT COAGULATION: A PROPENSITY SCORE–MATCHED COHORT STUDY

David James Tate

PEPPERMINT OIL VERSUS URSODEOXYCHOLIC ACID FOR PREVENTING RECURRENT CHOLEDOCHOLITHIASIS AFTER ERCP STONE CLEARANCE: A 2-YEAR PROSPECTIVE RANDOMIZED CONTROLLED TRIAL

Hongzhang Shen

Coeliac disease and gluten-related disorders

Julio Bai

Introduction: Are you stuck in the biliary cannulation nightmare: Wake up, here comes the sun

Andrea Anderloni

ACCURATE AND ROBUST COLLAGENOUS COLITIS DETECTION IN HISTOLOGICAL IMAGES USING FEATURES EXTRACTED FROM SEGMENTED AREAS BASED ON SUPERPIXELS TOGETHER WITH DEEP LEARNING

Rima Ramonaite

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ACCURATE AND ROBUST COLLAGENOUS COLITIS DETECTION IN HISTOLOGICAL IMAGES USING FEATURES EXTRACTED FROM SEGMENTED AREAS BASED ON SUPERPIXELS TOGETHER WITH DEEP LEARNING

Vytautas Kiudelis 1, Robertas Petrolis 1, Rima Ramonaite 1, Dainius Janciauskas 1, Juozas Kupcinskas 1, Jurgita Skieceviciene 1, Povilas Šabanas 1, Algimantas Kriščiukaitis 1

Affiliations

1 Lithuanian University of Health Sciences, Kaunas, Lithuania

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Abstract

Introduction

Collagenous colitis (CC) is a form of microscopic colitis (MC), the others being lymphocytic colitis (LC), incomplete CC and incomplete LC (1). It is an inflammatory disease of the large bowel that causes chronic watery diarrhoea, abdominal pain, faecal incontinence, nightly defecation, and weight loss, resulting in significantly impaired quality of life (2). Incidence of MC has increased significantly during the past decades in some countries and the main reason for this increase is thought to be an enhanced disease recognition (3). The diagnosis of MC is challenging as it can only be diagnosed upon histological examination of colonic biopsies taken from normal or near normal appearing mucosa (1). Histological interpretation of biopsies involves subjective evaluation leading to inter-rater variability discrepancies in diagnosis and treatment plan. Deep learning-based assistance system can objectivise diagnostic key feature selection leading to minimisation of inter-rater variability and improvement of diagnostic accuracy.

Aims & Methods

The aim of this pilot study was to develop an algorithm for robust segmentation of light microscopy images of histological specimen slides (tissue slides) emphasizing key diagnostic features of CC.
Histological specimens were fixed with formalin, embedded in paraffin, cut into 3 µm sections, and stained with haematoxylin and eosin (H&E) for histological examination. Images were taken using OLYMPUS IX71 light microscope (x20 magnification) equipped with Q IMAGING EXI aqua camera at (1392 x 1040 pix.) resolution and 24-bit pixel encoding. Registered image pixel values were normalized in RGB colour space by histogram alignment using empty tissue-less areas using an algorithm described previously (4). Superpixel technique using Simple Linear Iterative Clustering algorithm (5) was used for initial segmentation of the images. All 1000 superpixels defined in each image were annotated by the expert, indicating ones containing thickened subepithelial collagen layer as the sought class among the others containing the rest of the tissue indicated as normal class. The feed – forward neural network (implemented in MatLab environment) was trained to classify superpixels using their normalized histogram bin-counts of the pixel values as a feature. Due to significant inequality in the data set, where the number of sought class superpixels was significantly smaller than the number of the remaining ones, the training set was formed by equalising it to the lowest class case’s value (18761). Only randomly selected cases of the bigger class were included in the training set.

Results

The proposed algorithm was tested on images from 5 treatment-naive patients with newly diagnosed CC. Patients' histological specimens were rated by an expert pathologist and 50 images were chosen (with changes characteristic of CC and without). The classification training process with extracted data set took 0.13 seconds on personal computer with an AMD Ryzen Threadripper 3970X 32-Core, 3.70 GHz processor and 128GB of RAM memory, epochs for training was set to 30 (after tests the model was not improving after 30 epochs) and data shuffling was set to every-epoch. The algorithm showed 0.807 accuracy, 0.801 sensitivity and 0.813 specificity.

Conclusion

The shown ability of deep learning algorithm to classify histology image segments can assist the diagnostic process of CC emphasizing thickened subepithelial collagen layer – the essential diagnostic feature.

References

1. Miehlke S, Guagnozzi D, Zabana Y, Tontini GE, Fiehn AMK, Wildt S, et al. European guidelines on microscopic colitis: United European Gastroenterology (UEG) and European Microscopic Colitis Group (EMCG) statements and recommendations. United European Gastroenterol J. 2020;
2. Verhaegh BPM, Münch A, Guagnozzi D, Wildt S, Cebula W, Diac AR, et al. Course of Disease in Patients with Microscopic Colitis: A European Prospective Incident Cohort Study. J Crohns Colitis. 2021;15(7):1174–83.
3. Weimers P, Ankersen DV, Lophaven S, Bonderup OK, Münch A, Løkkegaard ECL, et al. Incidence and Prevalence of Microscopic Colitis between 2001 and 2016: A Danish Nationwide Cohort Study. J Crohns Colitis. 2021;14(12):1717–23.
4. Petrolis R., Čižas P., Borutaitė V., Kriščiukaitis A. Method of fluorescence imaging for evaluation of membrane potential in cultured neurons using transmembrane voltage sensitive dye. Biomedical engineering 2011: Proceedings of International Conference. 14:16-19, 2011.

5. Achanta R, Shaji A, Smith K, Lucchi A, Fua P, Susstrunk S. SLIC Superpixels Compared to State-of-the-art Superpixel Methods. IEEE Transactions on Pattern Analysis and Machine Intelligence, Volume 34, Issue 11, pp. 2274-2282, May 2012

Conference

UEG Week Vienna 2024

Topics

IBD

Submission format

Abstract

Session

IBD (Posters)

Citation

United European Gastroenterology Journal 2024; 12 (Supplement 8)

Published

2024

More Like This:

Exocrine pancreatic insufficiency: is there a pancreas-liver axis?

Ashkar Motaz

SPRAY COAGULATION REDUCES INTRAPROCEDURAL BLEEDING DURING ENDOSCOPIC SUBMUCOSAL DISSECTION COMPARED TO SWIFT COAGULATION: A PROPENSITY SCORE–MATCHED COHORT STUDY

David James Tate

PEPPERMINT OIL VERSUS URSODEOXYCHOLIC ACID FOR PREVENTING RECURRENT CHOLEDOCHOLITHIASIS AFTER ERCP STONE CLEARANCE: A 2-YEAR PROSPECTIVE RANDOMIZED CONTROLLED TRIAL

Hongzhang Shen

Coeliac disease and gluten-related disorders

Julio Bai

Introduction: Are you stuck in the biliary cannulation nightmare: Wake up, here comes the sun

Andrea Anderloni

ACCURATE AND ROBUST COLLAGENOUS COLITIS DETECTION IN HISTOLOGICAL IMAGES USING FEATURES EXTRACTED FROM SEGMENTED AREAS BASED ON SUPERPIXELS TOGETHER WITH DEEP LEARNING

Rima Ramonaite