Level of Fecal Calprotectin Correlates With Severity of Small Bowel Crohn’s Disease, Measured by Balloon-assisted Enteroscopy and Computed Tomography Enterography

Arai, T.; Takeuchi, Ken; Miyamura, Miyuki; Ishikawa, Rumiko; Yamada, Akihiro; Katsumata, Masao; Igarashi, Yoshinori; Suzuki, Yasuo

doi:10.1016/j.cgh.2016.08.015

Cited by 52 publications

(59 citation statements)

References 26 publications

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“…Our findings are in line with those of prior studies that demonstrated good correlation between high levels of FC with endoscopic scores and CTE[15,16]. Arai et al[16] evaluated the correlation between FC, CTE and balloon-assisted enteroscopy in patients with IBD. The authors created a novel CTE score in which four imaging variables were evaluated in five predefined ileal-colonic segments, and each variable was scored from 0 to 4 per segment.…”

Section: Discussionsupporting

confidence: 92%

Inter- and intraobserver agreement in computed tomography enterography in inflammatory bowel disease

Horvat

Tavares

Andrade

et al. 2016

WJG

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AIMTo evaluate intra- and interobserver agreement in imaging features in inflammatory bowel disease and comparison with fecal calprotectin (FC) levels.METHODSOur institutional computed tomography enterography (CTE) database was retrospectively queried to identify patients who underwent CTE from January 2014 to June 2015. Patient inclusion criteria were confirmed inflammatory bowel disease (IBD) and FC collected < 4 mo after CTE without any change in clinical treatment or surgical treatment during this interval. The exclusion criterion was poor image quality. Two blinded abdominal radiologists, with 12 and 3 years of experience analyzed the CTE regarding localization (small bowel, colonic, both, or no disease detected); type of IBD (inflammatory, stenosing, fistulizing, > 1 pattern, or normal); and signs of active disease (present or absent). In 42 of 44 patients evaluated, routine CTE reports were made by one of the readers who re-evaluated the CTEs ≥ 6 mo later, to determine the intraobserver agreement. FC was considered a sign of disease activity when it was higher than 250 μg/g.RESULTSForty-four patients with IBD (38 with Crohn’s disease and 6 with ulcerative colitis) were included. There was a moderate interobserver agreement regarding localization of IBD (κ = 0.540), type of disease (κ = 0.410) and the presence of active signs in CTE (κ = 0.419). There was almost perfect intraobserver agreement regarding localization, type and signs of active disease in IBD. The κ values were 0.902, 0.937 and 0.830, respectively. After a consensus between both radiologists regarding inflammatory activity in CTE, we found that 24 (85.7%) of 28 patients who were classified with active disease had elevated FC, and six (37.5%) of 16 patients without inflammatory activity in CTE had elevated FC (P = 0.003). The correlation between elevated FC and the presence of active disease in CTE was significant (κ = 0.495, P = 0.001).CONCLUSIONWe found almost perfect intraobserver and moderate interobserver agreement in the signs of active disease in CTE with concurrence of high FC levels.

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Section: Discussionsupporting

confidence: 92%

Inter- and intraobserver agreement in computed tomography enterography in inflammatory bowel disease

Horvat

Tavares

Andrade

et al. 2016

WJG

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“…Computed tomography enterography (CTE) and magnetic resonance enterography (MRE) are experiencing the largest expansions 10–13 . Recently, it has been reported that computed tomography could significantly increase diagnostic radiation, which may contribute to the development of malignancy, considering that patients with inflammatory bowel disease are at a relative high risk of developing gut carcinoma 14,15 .…”

Section: Introductionmentioning

confidence: 99%

Levels of Faecal Calprotectin and Magnetic Resonance Enterocolonography Correlate with Severity of Small Bowel Crohn’s Disease: A Retrospective Cohort Study

Cheng

Chen

et al. 2017

Sci Rep

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Few studies have evaluated the usefulness of fecal calprotectin (FC) or magnetic resonance enterography (MRE) in diagnosing active Crohn’s disease (CD) of the small bowel. In the study, we investigated the reliability of FC and MRE in assessing the activity of ileal CD and further explored the relationship between levels of FC and MRE scores. A total of 221 patients were diagnosed with ileal or ileo-colitis CD in our department between July 2012 and October 2016. The global magnetic resonance index of activity (MaRIA) correlated with the simple endoscopic score for CD (SES-CD) (r = 0.527, P = 0.005). When analysed segment-by-segment, a significant correlation was still observed (r = 0.590, P < 0.001). The SES-CD correlated closest with FC (r = 0.503), followed by CRP (r = 0.461), ESR (0.377) and the CDAI (r = 0.320). In receiver operating characteristic (ROC) analyses, the FC cut-off value of mucosal healing was 213.1 μg/g, with 76.1% sensitivity and 66.7% specificity. As for MaRIA, a cut-off value of 6.8 for each segment provided a sensitivity of 100% and a specificity of 79.2%. No agreement between MaRIA and FC levels was found. In conclusion, a combination of FC levels and MaRIA could be effective in monitoring mucosal activity in patients with small bowel CD.

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“…Conversely, a good correlation was reported in two different studies carried out in patients with ileal disease ( r = 0.6594; P < 0.0005; and r = 0.78, respectively) . This suggests, as in UC, that the best accuracy is observed, comparing repeated FC values over time, in the same patient.…”

Section: Resultsmentioning

confidence: 74%

“…Fecal calprotectin levels ranging from 140 to 200 μg/g were used by different authors for predicting endoscopically active disease, reporting sensitivities between 66% and 95.9% and specificities ranging from 52.3% to 95.5% …”

Section: Resultsmentioning

confidence: 99%

Is fecal calprotectin an accurate marker in the management of Crohn's disease?

Vernia

Ruscio

Stefanelli

et al. 2019

J of Gastro and Hepatol

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Although lacking validated cutoff values, fecal calprotectin (FC), besides C‐reactive protein, is considered the standard test for assessing disease activity in Crohn's disease (CD). The aim of the present review is to provide a general overview of the literature addressing the role of FC in the clinical and endoscopic assessment of disease activity in CD, seeking correlations with capsule endoscopy, response to therapy, prediction of relapse, and postoperative recurrence. A systematic search of the literature up to September 2019 was performed using Medline, Embase, and the Cochrane Library. Only papers written in English concerning FC in adult patients affected by CD were included. Pediatric studies, in vitro studies, animal studies, studies on blood/serum samples, and studies analyzing FC in ulcerative colitis or in both CD and ulcerative colitis were excluded. Out of 713 citations, 65 eligible studies were identified. FC showed high accuracy in the assessment of intestinal inflammation and response to therapy, in particular in colonic disease, thus proving a good surrogate marker for these aims. FC is useful in identifying patients at high risk for endoscopic relapse or postoperative recurrence, for optimizing or downstage therapy. Unfortunately, FC performs less well in small bowel CD. FC is an effective fecal marker in the management of CD patients, optimizing the use of endoscopic procedures. Owing to its diagnostic accuracy, FC may represent a cornerstone of the “treat‐to‐target” management strategy of CD patients.

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Level of Fecal Calprotectin Correlates With Severity of Small Bowel Crohn’s Disease, Measured by Balloon-assisted Enteroscopy and Computed Tomography Enterography

Cited by 52 publications

References 26 publications

Inter- and intraobserver agreement in computed tomography enterography in inflammatory bowel disease

Inter- and intraobserver agreement in computed tomography enterography in inflammatory bowel disease

Levels of Faecal Calprotectin and Magnetic Resonance Enterocolonography Correlate with Severity of Small Bowel Crohn’s Disease: A Retrospective Cohort Study

Is fecal calprotectin an accurate marker in the management of Crohn's disease?

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