{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T09:35:12Z","timestamp":1780047312825,"version":"3.53.1"},"reference-count":143,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T00:00:00Z","timestamp":1774483200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Endoscopic assessment is central to the management of inflammatory bowel disease (IBD), particularly within treat-to-target strategies. However, conventional high-definition white-light endoscopy (HD-WLE) is limited by interobserver variability and its inability to reliably reflect microscopic inflammation or predict long-term outcomes. Over the last decade, multiple technological innovations have reshaped the role of endoscopy in both disease activity monitoring and dysplasia surveillance. Methods: This narrative review provides a comprehensive and clinically oriented overview of emerging endoscopic technologies in IBD, including image-enhanced endoscopy, ultra-high-magnification techniques, artificial intelligence (AI), and molecular imaging. We discuss their diagnostic performance, prognostic implications, and potential integration into clinical practice. Results: Image-enhanced endoscopy improves visualization of subtle mucosal and vascular alterations and demonstrates stronger correlation with histological activity compared with HD-WLE alone. Confocal laser endomicroscopy and endocytoscopy enable in vivo microscopic assessment of epithelial architecture and barrier integrity, redefining remission beyond macroscopic healing. AI systems have shown expert-level performance in grading inflammatory severity in ulcerative colitis and high sensitivity in capsule endoscopy for Crohn\u2019s disease, supporting objective and reproducible assessment. In surveillance, targeted high-definition inspection has replaced random biopsies, while adjunctive optical and AI-based tools enhance lesion detection and characterization. Molecular imaging introduces a predictive dimension by enabling visualization of drug\u2013target engagement and dysplasia-specific pathways. Conclusions: Endoscopy in IBD is evolving from a descriptive modality toward a multimodal precision tool integrating enhanced imaging, AI-driven standardization, and molecular profiling. Although further validation and cost-effectiveness studies are required, these innovations have the potential to improve therapeutic stratification, surveillance strategies, and long-term patient outcomes.<\/jats:p>","DOI":"10.3390\/jcm15072539","type":"journal-article","created":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T15:10:24Z","timestamp":1774537824000},"page":"2539","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["New Technologies for IBD Endoscopy"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0076-8549","authenticated-orcid":false,"given":"Cristina","family":"Bezzio","sequence":"first","affiliation":[{"name":"Gastroenterology and Digestive Endoscopy Unit, IRCCS Humanitas Research Hospital Department of Gastroenterology, Rozzano, 20089 Milan, Italy"},{"name":"Department of Biomedical Sciences, Humanitas University, 20072 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valeria","family":"Farinola","sequence":"additional","affiliation":[{"name":"Gastroenterology and Digestive Endoscopy Unit, IRCCS Humanitas Research Hospital Department of Gastroenterology, Rozzano, 20089 Milan, Italy"},{"name":"Department of Biomedical Sciences, Humanitas University, 20072 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Privitera","sequence":"additional","affiliation":[{"name":"Gastroenterology and Digestive Endoscopy Unit, IRCCS Humanitas Research Hospital Department of Gastroenterology, Rozzano, 20089 Milan, Italy"},{"name":"Department of Biomedical Sciences, Humanitas University, 20072 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8543-4355","authenticated-orcid":false,"given":"Arianna","family":"Dal Buono","sequence":"additional","affiliation":[{"name":"Gastroenterology and Digestive Endoscopy Unit, IRCCS Humanitas Research Hospital Department of Gastroenterology, Rozzano, 20089 Milan, Italy"},{"name":"Department of Biomedical Sciences, Humanitas University, 20072 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7277-1053","authenticated-orcid":false,"given":"Roberto","family":"Gabbiadini","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, Humanitas University, 20072 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Loy","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, Humanitas University, 20072 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3440-4981","authenticated-orcid":false,"given":"Gianluca","family":"Franchellucci","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, Humanitas University, 20072 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erica","family":"Bartolotta","sequence":"additional","affiliation":[{"name":"Gastroenterology and Digestive Endoscopy Unit, IRCCS Humanitas Research Hospital Department of Gastroenterology, Rozzano, 20089 Milan, Italy"},{"name":"Department of Internal Medicine and Medical Therapeutics, University of Pavia, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-0198-9144","authenticated-orcid":false,"given":"Giulia","family":"Migliorisi","sequence":"additional","affiliation":[{"name":"Gastroenterology and Digestive Endoscopy Unit, IRCCS Humanitas Research Hospital Department of Gastroenterology, Rozzano, 20089 Milan, Italy"},{"name":"Department of Biomedical Sciences, Humanitas University, 20072 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1572-0118","authenticated-orcid":false,"given":"Alessandro","family":"Armuzzi","sequence":"additional","affiliation":[{"name":"Gastroenterology and Digestive Endoscopy Unit, IRCCS Humanitas Research Hospital Department of Gastroenterology, Rozzano, 20089 Milan, Italy"},{"name":"Department of Biomedical Sciences, Humanitas University, 20072 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2769","DOI":"10.1016\/S0140-6736(17)32448-0","article-title":"Worldwide incidence and prevalence of inflammatory bowel disease in the 21st century: A systematic review of population-based 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