Can MR Enterography and Diffusion-Weighted Imaging Predict Disease Activity Assessed by Simple Endoscopic Score for Crohn’s Disease?

Soydan, Levent; Demır, Ali; Özer, Serhat; Özkara, Selvinaz

doi:10.5334/jbsr.1521

Cited by 7 publications

(5 citation statements)

References 32 publications

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“…One gastroenterologist (with 15 years of experience in colonoscopy) reviewed colonoscopic images using the Simple Endoscopic Score for Crohn’s Disease (SES-CD) to retrospectively assess endoscopic disease activity. Disease activity was classified as follows: normal (remission), SES-CD < 4; mild, SES-CD 4–6; moderate, SES-CD 7–15; and severe, SES-CD > 16 [ 20 ].…”

Section: Methodsmentioning

confidence: 99%

Serial Changes in Body Composition and the Association with Disease Activity during Treatment in Patients with Crohn’s Disease

Lee

Kim²,

Ko³

et al. 2022

Diagnostics

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Objectives: To analyze serial changes in body composition and investigate the association between body composition changes and disease activity changes in patients with Crohn’s disease (CD). Methods: Seventy-one patients with CD who had been treated and followed-up at our institution were included. Two to four computed tomography images were acquired at baseline, and the 2–5-year, 5–8-year, and last follow-ups were selected per patient for body composition and disease activity analyses. Visceral fat area (VFA), skeletal muscle index (SMI; skeletal muscle area/height2), and subcutaneous fat area (SFA) were assessed using an artificial-intelligence-driven fully automated method. Disease activity was assessed using a modified computed tomography scoring system and the Simple Endoscopic Score for Crohn’s Disease. The associations between body composition, disease activity, and remission were investigated. Results: The mean age was 29.83 ± 11.27 years; most patients were men (48/71, 67.6%); and the median follow-up was 144 (12–264) months. Overall, VFA and SFA gradually increased, while SMI decreased during the follow-up. Sarcopenia was associated with the female sex, higher disease activities at baseline (p = 0.01) and the last follow-up (p = 0.001). SMI and SFA inversely correlated with the disease activity, i.e., the more severe the disease activity, the lower the SMI and SFA (p < 0.05). SMI at the last follow-up was the only significant predictor of remission (OR = 1.21, 95% confidence interval: 1.03–1.42, p = 0.021). Conclusion: SMI decreased while VFA and SFA increased during the treatment follow-up in patients with CD. Sarcopenia was associated with higher disease activity, and SMI and SFA inversely correlated with disease activity. SMI at the last follow-up was the significant factor for remission.

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Section: Methodsmentioning

confidence: 99%

Serial Changes in Body Composition and the Association with Disease Activity during Treatment in Patients with Crohn’s Disease

Lee

Kim²,

Ko³

et al. 2022

Diagnostics

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“…The value of diffusion-weighted MR enterography compared with contrast-enhanced MR enterography has not been conclusively established 7 8 ; consequently optimal sequence selection and patient preparation, as well as comparison to endoscopic findings, is the subject of current research 9 10 11 .…”

Section: Introductionmentioning

confidence: 99%

“…Die Wertigkeit der diffusionsgewichteten MR-Enterografie im Vergleich zur kontrastmittelunterstützten MR-Enterografie ist nicht abschließend geklärt 7 8 und die optimale Sequenzauswahl und Vorbereitung des Patienten sowie der Vergleich zum endoskopischen Befund ist Gegenstand der derzeitigen Forschung 9 10 11 .…”

Section: Introductionunclassified

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MR Enterography in Crohnʼs Disease: Comparison of Contrast Imaging with Diffusion-weighted Imaging and a special Form of Color Coding

Jakob

Backes

Schaefer

et al. 2022

Rofo

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Purpose We compared contrast-enhanced MR enterography with diffusion-weighted sequences to evaluate the validity of diffusion-weighted sequences for activity assessment in Crohnʼs disease compared to endoscopy. In addition, we investigated a new color-coded image post-processing technique in comparison with standard sequences and endoscopy. Materials and Methods Included were 197 MR enterographies (2015–2017) performed by using standardized examination protocols. The intestine was divided into 7 segments, which were compared separately. The accuracy of the MR examinations with regard to disease activity was validated using the Seo and MaRIA score and endoscopy findings. In addition, the image data were post-processed using a color-coded evaluation method (DCE tool on OsiriX). Results The comparison between contrast-enhanced and diffusion-weighted sequences showed a highly significant correlation for all bowel sections with a mean Spearman correlation coefficient of 0.876 (0.809–0.928). The color-coded image post-processing showed a sensitivity of 83.2 % and a specificity of 70.5 % in comparison with the MaRIA score. In comparison to endoscopy, a sensitivity of 81.3 % and a specificity of 70.5 %. In comparison with endoscopy, the MaRIA score showed a sensitivity of 80.2 % and a specificity of 84.0 % at a cut-off of 7. The visual score according to Seo showed a sensitivity of 85.7 % with a specificity of 77.0 % in the contrast-weighted examination and a sensitivity of 87.9 % and a specificity of 71.8 % for diffusion weighted images. Conclusion Diffusion-weighted sequences are as good as contrast-weighted sequences for assessing inflammatory activity in Crohnʼs disease. Contrast is often helpful for assessing complications, but this was not the purpose of this study. Visual imaging using color-coded data sets was similarly good at detecting inflammation. Key points: Citation Format

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“…The Simple Endoscopic Score for Crohn's Disease (SES-CD) was deemed the most appropriate tool for evaluating patient endoscopic response [24,25]. In this study, a SES-CD score between 0 and 2 suggested endoscopic remission, 3 to 6 mildly active, 7 to 15 moderately active and ≥16 severely active disease [25].…”

Section: Methodsmentioning

confidence: 96%

Anti-Mycobacterial Antibiotic Therapy Induces Remission in Active Paediatric Crohn’s Disease

et al. 2020

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Crohn’s disease is increasing in incidence and prevalence in younger people and is of a particularly aggressive nature. One emerging treatment targets Mycobacterium avium paratuberculosis (MAP), an organism implicated in the causation of Crohn’s disease. This study reviewed a cohort of paediatric patients with active Crohn’s disease treated with Anti-Mycobacterial Antibiotic Therapy (AMAT). Sixteen paediatric patients, the majority of whom had failed conventional immunosuppressive therapy, were treated with AMAT. Endoscopic remission was scored using the Simple Endoscopic Score for Crohn’s Disease and clinical remission was assessed using the Weighted Paediatric Crohn’s Disease Activity Index (wPCDAI). Inflammatory blood markers were also routinely recorded. Patients were followed up clinically and endoscopically during treatment after an average of two months (range 1–6) and 17 months (range 2–49), respectively. A significant reduction in both scores assessing clinical improvement (p < 0.001) and mucosal healing (p < 0.0078) was observed at these timepoints; 47% of patients had achieved clinical remission and 63% endoscopic remission. Haemoglobin and serum inflammatory markers normalised for more than 50% of the cohort by six months of treatment. No adverse effects were reported throughout treatment. This is the first report of Anti-Mycobacterial Antibiotic Therapy offering a safe and efficacious therapy for paediatric patients with Crohn’s disease. Further larger randomised studies are required in order to validate these findings.

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Can MR Enterography and Diffusion-Weighted Imaging Predict Disease Activity Assessed by Simple Endoscopic Score for Crohn’s Disease?

Cited by 7 publications

References 32 publications

Serial Changes in Body Composition and the Association with Disease Activity during Treatment in Patients with Crohn’s Disease

Serial Changes in Body Composition and the Association with Disease Activity during Treatment in Patients with Crohn’s Disease

MR Enterography in Crohnʼs Disease: Comparison of Contrast Imaging with Diffusion-weighted Imaging and a special Form of Color Coding

Anti-Mycobacterial Antibiotic Therapy Induces Remission in Active Paediatric Crohn’s Disease

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