PET/MRI for evaluating subclinical inflammation of ulcerative colitis

Shih, I‐Lun; Wei, Shu–Chen; Yen, Ruoh‐Fang; Chang, Chin‐Chen; Ko, C. M.; Lin, Been‐Ren; Shun, Chia‐Tung; Liu, Kao–Lang; Wong, Jau‐Min; Chang, Yu‐Cheng

doi:10.1002/jmri.25795

Cited by 16 publications

(13 citation statements)

References 25 publications

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“…The combination of MRI and 18 F-FDG-PET in recent studies on PET-MRI in inflammatory bowel disease also proved high accuracy in detecting inflamed bowel segments and correlated well with inflammation severity assessed by endoscopy [ 7 , 24 , 25 ]. Previous PET-MRI studies in inflammatory bowel disease mainly focused on the correlation of quantitative MRI and PET parameters with histological scores on a per segment basis [ 7 , 24 , 25 ]. We have already reported on a correlation between 18 F-FDG uptake and lymphocyte infiltration in a preclinical model of intestinal GvHD.…”

Section: Discussionmentioning

confidence: 99%

“…Previous bowel purgation might impede correlation between 18 F-FDG-PET and histological inflammatory grading and is considered as burdensome [ 24 ]. Oral intake of fluid prior to 18 F-FDG-PET included in many study protocols [ 7 , 24 , 25 ] might additionally alter the motility of the bowel, influencing 18 F-FDG uptake and quantitative MRI parameter [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

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18F-FDG-PET-MRI for the assessment of acute intestinal graft-versus-host-disease (GvHD)

et al. 2021

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Background Graft versus host disease (GvHD) is a frequent complication of allogeneic stem cell transplantation (alloSCT), significantly increasing mortality. Previous imaging studies focused on the assessment of intestinal GvHD with contrast-enhanced MRI/CT or 18F-FDG-PET imaging alone. The objective of this retrospective study was to elucidate the diagnostic value of a combined 18F-FDG-PET-MRI protocol in patients with acute intestinal GvHD. Methods Between 2/2015 and 8/2019, 21 patients with acute intestinal GvHD underwent 18F-FDG-PET-MRI. PET, MRI and PET-MRI datasets were independently reviewed. Readers assessed the number of affected segments of the lower gastrointestinal tract and the reliability of the diagnosis on a 5-point Likert scale and quantitative PET (SUVmax, SUVpeak, metabolic volume (MV)) and MRI parameter (wall thickness), were correlated to clinical staging of acute intestinal GvHD. Results The detection rate for acute intestinal GvHD was 56.8% for PET, 61.4% for MRI and 100% for PET-MRI. PET-MRI (median Likert-scale value: 5; range: 4–5) offers a significantly higher reliability of the diagnosis compared to PET (median: 4; range: 2–5; p = 0.01) and MRI alone (median: 4; range: 3–5; p = 0.03). The number of affected segments in PET-MRI (rs = 0.677; p < 0.001) and the MV (rs = 0.703; p < 0.001) correlated significantly with the clinical stage. SUVmax (rs = 0.345; p = 0.14), SUVpeak (rs = 0.276; p = 0.24) and wall thickening (rs = 0.174; p = 0.17) did not show a significant correlation to clinical stage. Conclusion 18F-FDG-PET-MRI allows for highly reliable assessment of acute intestinal GvHD and adds information indicating clinical severity.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

18F-FDG-PET-MRI for the assessment of acute intestinal graft-versus-host-disease (GvHD)

et al. 2021

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“…In a study focusing on PET/MRI implementation, Shih et al. (17) also referred to ADC as one of the studied MRI parameters. It was derived from an ADC map and identified as the lowest value in an ROI placed within a bowel wall.…”

Section: Discussionmentioning

confidence: 99%

Intravoxel incoherent motion MRI in evaluating inflammatory activity in ulcerative colitis: a pilot study

et al. 2020

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Background A non-invasive tool for the assessment of ulcerative colitis (UC) activity is needed for treatment control. Purpose To determine the efficacy of intravoxel incoherent motion (IVIM) in assessing inflammatory activity in UC. Material and Methods In this prospective study, 20 adult patients underwent 3.0-T magnetic resonance imaging (MRI) IVIM diffusion-weighted imaging (DWI) with 10 b-values (0–900 s/mm2) 0–6 days after biopsies entailing colonoscopy. The inflammatory activity of large bowel segments was graded on endoscopy with Mayo score and on pathology with a six‑grade classification system. IVIM‑derived parameters (f, D, and D*) calculated from regions of interest placed within the bowel wall were correlated with both scores (56 and 34 bowel segments, respectively). Radiologists were blinded to endoscopy and pathology results. A T-test and Wilcoxon rank sum test was used in comparisons and receiver operating characteristic curve analysis was performed. Results Statistically significant differences were found between histopathologically inactive or mild activity and moderate to severe activity in f (respectively: mean = 0.19 and mean = 0.28, P = 0.024; area under the curve [AUC] = 0.723, sensitivity 0.82, specificity 0.59, accuracy 0.67 for a 0.185 cut-off value) and D (mean = 1.34 × 10−3mm2/s and mean = 1.07 × 10−3mm2/s, P = 0.0083; AUC = 0.735, sensitivity 0.91, specificity 0.54, accuracy 0.66 for cut-off value 1.24 × 10−3mm2/s). No significant difference in D* was noted. No significant correlation between Mayo endoscopic subscore, and f, D, nor D* was found. Conclusion IVIM perfusion fraction correlates with UC activity and might represent emerging tool in assessment of inflammatory activity.

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“…Shih et al. (13) demonstrated recently that PET/MRI parameters are useful in detecting moderate and severe inflammatory lesions in colonic mucosa. Li et al.…”

Section: Discussionmentioning

confidence: 99%

The value of combined positron emission tomography/magnetic resonance imaging to diagnose inflammatory bowel disease: a prospective study

et al. 2020

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Background The clinical utility of positron emission tomography/magnetic resonance imaging (PET/MRI) in comparison to standard work-up with patients with known or suspected inflammatory bowel disease (IBD) is unknown. Purpose To evaluate the value of 18F-fluorodeoxyglucose (18F-FDG) PET/MRI in the diagnostics of IBD and further compare the data obtained using PET/MRI to histological findings. Materials and Methods Ten patients with relapse in IBD or with symptoms of suspected IBD were recruited either from a gastroenterology outpatient clinic or from a hospital ward. Intestinal inflammation was assessed with histology and 18F-FDG PET/MRI. Maximum standard uptake values (SUVmax) were calculated in six regions of the intestine (small bowel, ascending, transverse, descending and sigmoid colon, and rectum) and compared to histological analysis of inflammation activity. Results The study showed that both the inflammation activity ( P = 0.008) and the region of the biopsy in the intestine ( P = 0.015) had a significant effect on SUV. SUVs obtained from severe inflammation activity emerged significantly from the background ( P = 0.006). In addition, the SUVs obtained from moderate inflammation raised from background, but the difference was not statistically significant ( P = 0.083), while SUVs of mild inflammation were at the same level with SUVs of normal bowel wall ( P = 0.988). Conclusion 18F-FDG PET/MRI is a promising method of detecting especially severe inflammatory bowel lesions. More data are required to define its sensitivity and specificity.

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PET/MRI for evaluating subclinical inflammation of ulcerative colitis

Abstract: 1 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2018;47:737-745.

Cited by 16 publications

References 25 publications

18F-FDG-PET-MRI for the assessment of acute intestinal graft-versus-host-disease (GvHD)

18F-FDG-PET-MRI for the assessment of acute intestinal graft-versus-host-disease (GvHD)

Intravoxel incoherent motion MRI in evaluating inflammatory activity in ulcerative colitis: a pilot study

The value of combined positron emission tomography/magnetic resonance imaging to diagnose inflammatory bowel disease: a prospective study

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