Diffusion-weighted MRI in inflammatory bowel disease

Pouillon, Lieven; Laurent, V.; Pouillon, Marc; Bossuyt, Peter; Bonifacio, Cristiana; Danese, Silvio; Deepak, Parakkal; Loftus, Edward V.; Peyrin–Biroulet, Laurent

doi:10.1016/s2468-1253(18)30054-2

Cited by 23 publications

(16 citation statements)

References 95 publications

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“…In our opinion, the limited spatial resolution in ssDWI could be one important reason leading to differences in DWI diagnostic accuracy between studies. Indeed, Pouillon et al have pointed out in a recent review that the deficiency of anatomic detail in DWI is disadvantageous for assessment of intra‐abdominal CD complications 26 . Our study showed that increasing in‐plane resolution by a factor of 1.5 by acquiring data with increased matrix size and higher SENSE factor resulted in poorer image quality and diagnostic accuracy.…”

Section: Discussionmentioning

confidence: 61%

Multi‐shot Diffusion‐Weighted MRI With Multiplexed Sensitivity Encoding (MUSE) in the Assessment of Active Inflammation in Crohn's Disease

Chang

Chen

Chung

et al. 2021

Magnetic Resonance Imaging

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Background Single‐shot diffusion‐weighted imaging (ssDWI) has been shown useful for detecting active bowel inflammation in Crohn's disease (CD) without MRI contrast. However, ssDWI suffers from geometric distortion and low spatial resolution. Purpose To compare conventional ssDWI with higher‐resolution ssDWI (HR‐ssDWI) and multi‐shot DWI based on multiplexed sensitivity encoding (MUSE‐DWI) for evaluating bowel inflammation in CD, using contrast‐enhanced MR imaging (CE‐MRI) as the reference standard. Study Type Prospective. Subjects Eighty nine patients with histological diagnosis of CD from previous endoscopy (55 male/34 female, age: 17–69 years). Field Strength/Sequences ssDWI (2.7 mm × 2.7 mm), HR‐ssDWI (1.8 mm × 1.8 mm), MUSE‐DWI (1.8 mm × 1.8 mm) based on echo‐planar imaging, T2‐weighted imaging, and CE‐MRI sequences, all at 1.5 T. Assessment Five raters independently evaluated the tissue texture conspicuity, geometry accuracy, minimization of artifacts, diagnostic confidence, and overall image quality using 5‐point Likert scales. The diagnostic performance (sensitivity, specificity and accuracy) of each DWI sequences was assessed on per‐bowel‐segment basis. Statistical Tests Inter‐rater agreement for qualitative evaluation of each parameter was measured by the intra‐class correlation coefficient (ICC). Paired Wilcoxon signed‐rank tests were performed to evaluate the statistical significance of differences in qualitative scoring between DWI sequences. A P value <0.05 was considered to be statistically significant. Results Tissue texture conspicuity, geometric distortions, and overall image quality were significantly better for MUSE‐DWI than for ssDWI and HR‐ssDWI with good agreement among five raters (ICC: 0.70–0.89). HR‐ssDWI showed significantly poorer performance to ssDWI and MUSE‐DWI for all qualitative scores and had the worst diagnostic performance (sensitivity of 57.0% and accuracy of 87.3%, with 36 undiagnosable cases due to severe artifacts). MUSE‐DWI showed significantly higher sensitivity (97.5% vs. 86.1%) and accuracy (98.9% vs. 95.1%) than ssDWI for detecting bowel inflammation. Data Conclusion MUSE‐DWI was advantageous in assessing bowel inflammation in CD, resulting in improved spatial resolution and image quality. Level of Evidence 2 Technical Efficacy Stage 2

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Section: Discussionmentioning

confidence: 61%

Multi‐shot Diffusion‐Weighted MRI With Multiplexed Sensitivity Encoding (MUSE) in the Assessment of Active Inflammation in Crohn's Disease

Chang

Chen

Chung

et al. 2021

Magnetic Resonance Imaging

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“…This conventional method is commonly applied to a range of cancer and noncancer applications (e.g. assessment of inflammatory changes in the bowel [ 67 , 68 ]) and, as such, is not tissue specific, with multiple pathological mechanisms contributing to signal change. Consequently, whilst standard DWI is an improvement over anatomical imaging alone, it still lacks specificity [ 69 ].…”

Section: Novel Imaging Methodsmentioning

confidence: 99%

Emerging methods for prostate cancer imaging: evaluating cancer structure and metabolic alterations more clearly

Retter¹,

Gong²,

Syer³

et al. 2021

Molecular Oncology

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Imaging plays a fundamental role in all aspects of the cancer management pathway. However, conventional imaging techniques are largely reliant on morphological and size descriptors that have well known limitations, particularly when considering targeted-therapy response monitoring. Thus, new imaging methods have been developed to characterise cancer and are now routinely implemented, such as diffusion weighted imaging (DWI), dynamic contrast enhancement (DCE), positron emission technology (PET) and magnetic resonance spectroscopy (MRS). However, despite the improvement these techniques have enabled, limitations still remain. Novel imaging methods are now emerging, intent on further interrogating cancers.

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“…It can be performed without the need for intravenous administration of gadolinium-based contrast agent. Due to restricted microscopic diffusion of water molecules, a high enhancement diffusion signal and a low apparent diffusion coefficient (ADC) value have been detected in inflamed bowel segments in IBD patients and allowed the identification of active CD [15]. A systematic review and meta-analysis by Choi et al found DWI to be very accurate in evaluating CD activity: the pooled sensitivity and specificity were 92.9% and 91%, respectively [30].…”

Section: Assessing Disease Activitymentioning

confidence: 99%

“…New magnetic resonance imaging (MRI)based techniques can represent an added value in the monitoring of IBD, overcoming some limitations of conventional MRE and providing further information. Among these, diffusion-weighted imaging (DWI) has demonstrated good accuracy and reliability, but lacks an adequate standardization of DWI scanners and procedures [15]. In addition to CT and MRE, bowel ultrasound (BUS) is an inexpensive, noninvasive, readily available and well tolerated procedure that does not require either bowel preparation or contrast agent and can be performed at the point-of-care [16].…”

Section: Introductionmentioning

confidence: 99%

Cross-Sectional Imaging Instead of Colonoscopy in Inflammatory Bowel Diseases: Lights and Shadows

Alfarone

Buono

Craviotto

et al. 2022

JCM

Self Cite

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International guidelines recommend a treat-to-target strategy with a close monitoring of disease activity and therapeutic response in inflammatory bowel diseases (IBD). Colonoscopy (CS) represents the current first-line procedure for evaluating disease activity in IBD. However, as it is expensive, invasive and poorly accepted by patients, CS is not appropriate for frequent and repetitive reassessments of disease activity. Recently, cross-sectional imaging techniques have been increasingly shown as reliable tools for assessing IBD activity. While computed tomography (CT) is hampered by radiation risks, routine implementation of magnetic resonance enterography (MRE) for close monitoring is limited by its costs, low availability and long examination time. Novel magnetic resonance imaging (MRI)-based techniques, such as diffusion-weighted imaging (DWI), can overcome some of these weaknesses and have been shown as valuable options for IBD monitoring. Bowel ultrasound (BUS) is a noninvasive, highly available, cheap, and well accepted procedure that has been demonstrated to be as accurate as CS and MRE for assessing and monitoring disease activity in IBD. Furthermore, as BUS can be quickly performed at the point-of-care, it allows for real-time clinical decision making. This review summarizes the current evidence on the use of cross-sectional imaging techniques as cost-effective, noninvasive and reliable alternatives to CS for monitoring patients with IBD.

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Diffusion-weighted MRI in inflammatory bowel disease

Cited by 23 publications

References 95 publications

Multi‐shot Diffusion‐Weighted MRI With Multiplexed Sensitivity Encoding (MUSE) in the Assessment of Active Inflammation in Crohn's Disease

Multi‐shot Diffusion‐Weighted MRI With Multiplexed Sensitivity Encoding (MUSE) in the Assessment of Active Inflammation in Crohn's Disease

Emerging methods for prostate cancer imaging: evaluating cancer structure and metabolic alterations more clearly

Cross-Sectional Imaging Instead of Colonoscopy in Inflammatory Bowel Diseases: Lights and Shadows

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