The establishment of a regression model from four modes of ultrasound to predict the activity of Crohn's disease

Jing, Ji-Gang; Wu, Yuting; Hu, Zhang; Zhang, Yan; Mu, Jie; Luo, Yan; Zhuang, Hua

doi:10.1038/s41598-020-79944-1

Cited by 7 publications

(4 citation statements)

References 34 publications

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“…Multi-modal IUS offers advantages over single-modal IUS, providing a global disease assessment, with a high reproducibility thanks to its quantitative measurements and a strong correlation with reference standard methods. 26 A few studies have already evaluated the combination of different IUS techniques to assess the activity in CD, and a multimodal IUS parametric regression model was designed by Jing et al 27 to distinguish active from inactive patients, but no data on treatment monitoring are available so far.…”

Section: Discussionmentioning

confidence: 99%

Multimodal dynamic ultrasound approach as predictor of response in patients with Crohn’s disease treated with ustekinumab

Ainora,

Liguori,

Mignini

et al. 2024

Therap Adv Gastroenterol

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Background: The approval of ustekinumab (UST) has opened new options for the treatment of Crohn’s disease (CD), but potential markers predicting the efficacy of this interleukin-12/23 inhibitor are lacking. Contrast-enhanced ultrasound (CEUS) is non-invasive alternative to endoscopy, demonstrating early transmural changes after treatment induction. Objectives: We conducted a prospective monocentric study aiming to explore the value of multimodal intestinal ultrasound (IUS) in predicting the response to UST in patients with active CD who have been previously exposed to anti-tumour necrosis factor α (TNFα). Design and methods: Consecutive patients with moderate-to-severe CD involving the terminal ileum who were scheduled to begin UST therapy were enrolled between January 2020 and October 2021 in the inflammatory bowel diseases outpatient centre. A complete IUS evaluation, including B-mode, Doppler, dynamic CEUS and elastography, was performed at the time of induction (T0) and after 8 (T1), 16 (T2), 24 (T3) and 48 (T4) weeks of therapy. Each IUS parameter and their variations from baseline were correlated with endoscopic response and mucosal healing after 1 year. Results: A total of 52 patients were included, 29 (55.8%) of which reached endoscopic response at T4. The univariate analysis revealed that, between T3 and T0, the percentage changes of bowel wall thickness, Limberg score, mean signal intensity, rise time, wash-in rate, C reactive protein and Harvey–Bradshaw Index were associated with long-term therapeutic outcome. Based on the above parameters, we developed an IUS score that showed a good performance in predicting 1 year-endoscopic response (area under the curve: 0.91). Conclusion: Multimodal ultrasound could be helpful to predict long-term therapeutic outcome in patients with CD treated with UST. Registration: NCT05987501.

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Section: Discussionmentioning

confidence: 99%

Multimodal dynamic ultrasound approach as predictor of response in patients with Crohn’s disease treated with ustekinumab

Ainora,

Liguori,

Mignini

et al. 2024

Therap Adv Gastroenterol

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“…Using multimodal IUS (with B-mode, color doppler, CEUS, and SWE), Jing J. et al identified seven US parameters to be significantly different in active vs. inactive CD patients and established a regression model using CDAI as the reference standard for confirming the presence of disease activity. Among the different parameters, the texture of enhancement (TE) obtained by CEUS had the second-largest impact on the regression model [54].…”

Section: Contrast-enhanced Ultrasound (Ceus)mentioning

confidence: 99%

Current Developments and Role of Intestinal Ultrasound including the Advent of AI

Tagliamonte,

Santagata,

Fraquelli

2024

Diagnostics

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Intestinal ultrasound is a non-invasive, safe, and cost-effective technique to study the small and large intestines. In addition to conventional B-mode and color doppler imaging, new US tools have been developed in more recent years that provide auxiliary data on many GI conditions, improving the diagnosis and assessment of relevant outcomes. We have reviewed the more recent literature (from 2010 onwards) on auxiliary tools in bowel ultrasound such as elastography techniques, CEUS, SICUS, and the potential contribution by artificial intelligence (AI) to overcome current intestinal ultrasound limitations. For this scoping review, we performed an extensive literature search on PubMed and EMBASE to identify studies published until December 2023 and investigating the application of elastography techniques, CEUS, SICUS, and AI in the ultrasonographic assessment of the small and large intestines. Multiparametric intestinal ultrasound shows promising capabilities in Crohn’s disease, while less is known about the role in ulcerative colitis. Despite some evidence, the CEUS role as a point-of-care examination tool for rare conditions such as intestinal GvHD and ischemic small bowel disease seems promising, possibly avoiding the need to perform further cross-sectional imaging. The use of AI in intestinal ultrasound is still anecdotical and limited to acute appendicitis.

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“…Besides this, the Limberg score is widely used to assess disease activity with US [22]. A recent study proposed a regression model based on multimodal multi-parametric ultrasound to assess CD activity [23]. In order to differentiate between inflammation and fibrosis, Bhatnagar et al compared sonographic features with histomorphology in CD patients [24].…”

Section: In Vivo Imagingmentioning

confidence: 99%

Extracellular Matrix Components as Diagnostic Tools in Inflammatory Bowel Disease

Golusda

Kühl

Siegmund

et al. 2021

Biology

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Work from the last years indicates that the extracellular matrix (ECM) plays a direct role in various cellular processes, including proliferation, migration and differentiation. Besides homeostatic processes, its regulatory function in inflammation becomes more and more evident. In inflammation, such as inflammatory bowel disease, the ECM composition is constantly remodeled, and this can result in a structuring of fistulizing disease course. Thus, tracking early ECM changes might bear the potential to predict the disease course. In this review, we provide an overview of relevant diagnostic methods, focusing on ECM changes.

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The establishment of a regression model from four modes of ultrasound to predict the activity of Crohn's disease

Cited by 7 publications

References 34 publications

Multimodal dynamic ultrasound approach as predictor of response in patients with Crohn’s disease treated with ustekinumab

Multimodal dynamic ultrasound approach as predictor of response in patients with Crohn’s disease treated with ustekinumab

Current Developments and Role of Intestinal Ultrasound including the Advent of AI

Extracellular Matrix Components as Diagnostic Tools in Inflammatory Bowel Disease

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