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

Abstract

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.

Colonocyte keratin 7 is expressed de novo in inflammatory bowel diseases and associated with pathological changes and drug-resistance

“…The protocol was approved by the ethics committee of the Hospital District of Southwest Finland (decision 66/1801/2014; §264), and the research grant of Turku University Hospital was received by the director of the Division of Medicine (decision TO5/039/14; 13604). Patient recruitment, exclusion criteria, diagnostic methods and sample collection have been presented elsewhere 50 . All patients were informed about the nature of the study, and they signed an informed consent before participating in the study.…”

PET Imaging of System xC− in Immune Cells for Assessment of Disease Activity in Mice and Patients with Inflammatory Bowel Disease

“…The low background uptake of 18 F-FSPG would be especially advantageous in detecting inflammatory lesions in the intestine (12,13), an organ in which the utilization of conventional 18 F-fluorodeoxyglucose imaging may be limited because of physiologic uptake. 18 F-fluorodeoxyglucose PET may also be limited in differentiating mildly active IBD from endoscopic remission (14,15), showing an adequate accuracy only for detecting moderate-to-severe endoscopic disease (16,17). The objective of this study was to evaluate whether the in vivo assessment of system xC¯ in immune cells provides information on the dysregulated immune responses responsible for chronic active inflammation in IBD, thereby assessing the disease activity.…”