Assessment of therapeutic response in Crohn's disease using quantitative dynamic contrast enhanced MRI (DCE-MRI) parameters

Zhu, Jianguo; Zhang, Faming; Zhou, Jinfa; Li, Haige

doi:10.1097/md.0000000000007759

Cited by 14 publications

(5 citation statements)

References 38 publications

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“…The comparison of CRP levels and other inflammatory indicators in the corresponding period also verified that thalidomide can reduce the degree of inflammatory activity and alleviate the mucosal damage caused by stress factors, with good efficacy. 13 Unlike with the use of thalidomide for other indications, no malignant side effects caused by thalidomide were reported in the present study, suggesting that its use combined with FMT capsules is a very effective adjuvant therapy.…”

Section: Discussioncontrasting

confidence: 58%

The Effects of Multi-Donor Fecal Microbiota Transplantation Capsules Combined with Thalidomide on Hormone-Dependent Ulcerative Colitis

Guo¹,

Zhu²,

Yang³

et al. 2022

IDR

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This study aimed to assess the effects of multi-donor fecal microbiota transplantation (FMT) capsules combined with thalidomide on hormone-dependent ulcerative colitis (UC). Methods: A total of 59 patients with steroid-dependent UC treated at the Gastroenterology Department of the First Affiliated Hospital of Xinxiang Medical University between January 2017 and January 2019 were enrolled in this study. Using a random number table, the patients were divided into two groups: a group treated with FMT capsules (the FMT group) and a group treated with FMT capsules and thalidomide (the FMT+S group). Multi-donor FMT capsules were prepared, and all subjects and stool donors followed the FMT pathway for FMT transplantation. Each patient's Mayo score, C-reactive protein (CRP) level, and level of fecal calprotectin before FMT treatment and at week 1 and week 13 after treatment were recorded. All patients were followed up for 15 weeks. Results: A total of 56.7% of the patients (34/59) achieved a therapeutic response at the end of the research period. Compared with the FMT group, the FMT+S group had better clinical benefit (P < 0.05). In the comparison of efficacy at week 1 and week 13 after treatment, the Mayo scores, calprotectin levels, and CRP indexes in the FMT+S group were better than those in the FMT group (P < 0.05). There were no serious adverse events in the treatment process or during follow-up. Conclusion: A combination of FMT capsules and thalidomide provides a treatment choice for patients with hormone-dependent UC, and it can be used as an adjuvant therapy. However, large-scale, multi-center, and prospective trials are required to further verify the reliability of this treatment.

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Section: Discussioncontrasting

confidence: 58%

The Effects of Multi-Donor Fecal Microbiota Transplantation Capsules Combined with Thalidomide on Hormone-Dependent Ulcerative Colitis

Guo¹,

Zhu²,

Yang³

et al. 2022

IDR

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“…Patients will be scanned in the supine position. The MRE is carried out following the protocol [18, 19], including: (1) coronal T2 (single shot fast spin-echo [SSFSE]) through the abdomen and pelvis with breath-holding (Tck = 5 mm, spacing = 1 mm; TR = 2800 ms, TE = 70 ms); (2) axial T2 FSE fat-suppressed images covering the abdomen and pelvis, free-breathing with navigator triggering (Tck = 4 mm, spacing = 2 mm; TR = 12,000 ms, TE = 90 ms); and (3) axial T1 LAVA-Flex Mask through the abdomen and pelvis with breath-holding (Tck = 4 mm, spacing = 0 mm; TR = 4500 ms, TE = 1.7 ms). DW-MRI and DCE-MRI will be carried out after MRE.…”

Section: Methodsmentioning

confidence: 99%

The bowel preparation for magnetic resonance enterography in patients with Crohn’s disease: study protocol for a randomized controlled trial

Dai

Zhang

et al. 2019

Trials

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BackgroundAdequate bowel preparation is required for magnetic resonance enterography (MRE), which can be achieved by administering contrast solution after mid-gut tubing or taking contrast solution orally. We present the design of randomized controlled trial (RCT) to compare the efficacy and compliance of bowel preparation between mid-gut tubing and oral administering for MRE in patients with Crohn’s disease (CD).Methods/designThis is an open-label, multicenter RCT. Ninety-six patients with CD in need of MRE examination and mid-gut tubing (prepared for fecal microbiota transplantation and/or enteral nutrition), aged ≥ 14 years, will be included. Patients will be randomized 1:1 into either bowel preparation by oral administering (oral group) or bowel preparation through mid-gut transendoscopic enteral tubing (TET) (tubing group). The primary outcome measures are: (1) degree of discomfort before/during/after bowel preparation for MRE using a visual 5-grade scale (1 = few, 5 = very severe); and (2) grade of bowel distention evaluated by a 5-grade scale (1 = 0–20% segmental distention, 2 = 20–40% distention, 3 = 40–60% distention, 4 = 60–80% distention, 5 = 80–100% distention). The secondary outcome measure is the accuracy of lesion detection through MRE confirmed by colonoscopy which is evaluated by a 5-point scale.DiscussionThe outcome of this study is expected to provide a novel effective clinical protocol of bowel preparation for MRE in patients with CD. We hope to highlight the concept of physician–patient satisfaction based on different methods of bowel preparation for MRE.Trial registrationClinicalTrials.gov, NCT03541733. Registered on 30 May 2018.Electronic supplementary materialThe online version of this article (10.1186/s13063-018-3101-x) contains supplementary material, which is available to authorized users.

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“…The gastroenterologists scored the ileocolonoscopy ndings in consensus for each segment according to SES-CD during endoscopy. The bowel segments were classi ed by SES-CD as inactive (0-2), mild (3)(4)(5)(6), or moderate-severe (≥ 7) [15]. Discrepancies between reviewers were resolved by consensus reading.…”

Section: Reference Standard For Intestinal In Ammatory Activitymentioning

confidence: 99%

“…There are multiple well-established scoring criteria to assess disease activity in CD, including Crohn's disease activity index and Harvey-Bradshaw index based on symptoms and physical signs, Crohn's disease endoscopic index of severity and simple endoscopic score for Crohn's disease (SES-CD) according to endoscopic ndings, magnetic resonance index of activity (MaRIA), Clermont score and magnetic resonance enterograpgy global score (MEGS) using magnetic resonance enterography [3][4][5][6]. Among them, endoscopic scoring has been commonly used and considered as the reference standard in many studies.…”

Section: Introductionmentioning

confidence: 99%

Computed Tomography Enterography-Based Radiomics Nomograms to Predict Inflammatory Activity for Ileocolonic Crohn’s Disease

Ma,

Zhu,

Cui

et al. 2024

Preprint

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ObjectivesTo develop and validate nomograms, derived from morphological features, and computed tomography enterography (CTE) -based radiomics, for evaluating inflammatory activity in patients with ileocolonic Crohn’s disease (CD). MethodsA total of 54 CD patients (237 bowel segments) with clinically confirmed CD were retrospectively reviewed. The simple endoscopic score for Crohn’s disease (SES-CD) was used as a reference standard to quantify the degree of mucosal inflammation and evaluate the disease severity. Radiomics and image morphological features were extracted in the training cohort, and then a morphological model (M-score) and a radiomics model (Rad-score) were built respectively. A combined nomogram was further generated by incorporating M-score and Rad-score. Predictive values of each model were assessed using receiver operating characteristic (ROC) curve analysis. Calibration curve and decision curve analysis (DCA) were employed to evaluate the accuracy and clinical applicability of the nomogram in the testing cohort. ResultsThe area under the ROC curve (AUC) of the nomogram, based on the stenosis, comb sign and Rad-score, was 0.834 [95% confidence interval (CI): 0.728–0.940] for distinguishing active from remissive disease. Moreover, the nomogram built using comb sign and Rad-score also achieved satisfied AUC [0.781 (95%CI: 0.611–0.951)] in distinguishing mild activity from moderate-to-severe activity. The calibration curve and DCA confirmed the accuracy and clinical utility of both nomograms. Conclusions Nomograms constructed by combining CTE-based radiomics and morphological features might be a useful supporting tool for grading inflammatory activity, aiding clinical decision-making for the management of CD.

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Assessment of therapeutic response in Crohn's disease using quantitative dynamic contrast enhanced MRI (DCE-MRI) parameters

Cited by 14 publications

References 38 publications

The Effects of Multi-Donor Fecal Microbiota Transplantation Capsules Combined with Thalidomide on Hormone-Dependent Ulcerative Colitis

The Effects of Multi-Donor Fecal Microbiota Transplantation Capsules Combined with Thalidomide on Hormone-Dependent Ulcerative Colitis

The bowel preparation for magnetic resonance enterography in patients with Crohn’s disease: study protocol for a randomized controlled trial

Computed Tomography Enterography-Based Radiomics Nomograms to Predict Inflammatory Activity for Ileocolonic Crohn’s Disease

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