Dataset Information

Quantitative Magnetic Resonance Imaging in Perianal Crohn's Disease at 1.5 and 3.0 T: A Feasibility Study.

ABSTRACT: Perianal Crohn's Disease (pCD) is a common manifestation of Crohn's Disease. Absence of reliable disease measures makes disease monitoring unreliable. Qualitative MRI has been increasingly used for diagnosing and monitoring pCD and has shown potential for assessing response to treatment. Quantitative MRI sequences, such as diffusion-weighted imaging (DWI), dynamic contrast enhancement (DCE) and magnetisation transfer (MT), along with T2 relaxometry, offer opportunities to improve diagnostic capability. Quantitative MRI sequences (DWI, DCE, MT and T2) were used in a cohort of 25 pCD patients before and 12 weeks after biological therapy at two different field strengths (1.5 and 3 T). Disease activity was measured with the Perianal Crohn's Disease Activity index (PDAI) and serum C-reactive protein (CRP). Diseased tissue areas on MRI were defined by a radiologist. A baseline model to predict outcome at 12 weeks was developed. No differences were seen in the quantitative MR measured in the diseased tissue regions from baseline to 12 weeks; however, PDAI and CRP decreased. Baseline PDAI, CRP, T2 relaxometry and surgical history were found to have a moderate ability to predict response after 12 weeks of biological treatment. Validation in larger cohorts with MRI and clinical measures are needed in order to further develop the model.

SUBMITTER: Alyami A

PROVIDER: S-EPMC8624877 | biostudies-literature | 2021 Nov

REPOSITORIES: biostudies-literature

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Quantitative Magnetic Resonance Imaging in Perianal Crohn's Disease at 1.5 and 3.0 T: A Feasibility Study.

Alyami Ali A Hoad Caroline L CL Tench Christopher C Bannur Uday U Clarke Christopher C Latief Khalid K Argyriou Konstantinos K Lobo Alan A Lung Philip P Baldwin-Cleland Rachel R Sahnan Kapil K Hart Ailsa A Limdi Jimmy K JK Mclaughlin John J Atkinson David D Parker Geoffrey J M GJM O'Connor James P B JPB Little Ross A RA Gowland Penny A PA Moran Gordon W GW

Diagnostics (Basel, Switzerland) 20211117 11

Perianal Crohn's Disease (pCD) is a common manifestation of Crohn's Disease. Absence of reliable disease measures makes disease monitoring unreliable. Qualitative MRI has been increasingly used for diagnosing and monitoring pCD and has shown potential for assessing response to treatment. Quantitative MRI sequences, such as diffusion-weighted imaging (DWI), dynamic contrast enhancement (DCE) and magnetisation transfer (MT), along with T2 relaxometry, offer opportunities to improve diagnostic capa ...[more]

PMID: 34829482

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Project description:To evaluate the imaging course of Crohn's disease (CD) patients with perianal fistulas on long-term maintenance anti-tumor necrosis factor (TNF)-α therapy and identify predictors of deep remission.All patients with perianal CD treated with anti-TNF-α therapy at our tertiary care center were evaluated by magnetic resonance imaging (MRI) and clinical assessment. Two MR examinations were performed: at initiation of anti-TNF-α treatment and then at least 2 years after. Clinical assessment (remission, response and non-response) was based on Present's criteria. Rectoscopic patterns, MRI Van Assche score, and MRI fistula activity signs (T2 signal and contrast enhancement) were collected for the two MR examinations. Fistula healing was defined as the absence of T2 hyperintensity and contrast enhancement on MRI. Deep remission was defined as the association of both clinical remission, absence of anal canal ulcers and healing on MRI. Characteristics and imaging patterns of patients with and without deep remission were compared by univariate and multivariate analyses.Forty-nine consecutive patients (31 females and 18 males) were included. They ranged in age from 14-70 years (mean, 33 years). MRI and clinical assessment were performed after a mean period of exposure to anti-TNF-α therapy of 40 ± 3.7 mo. Clinical remission, response and non-response were observed in 53.1%, 20.4%, and 26.5% of patients, respectively. Deep remission was observed in 32.7% of patients. Among the 26 patients in clinical remission, 10 had persisting inflammation of fistulas on MRI (T2 hyperintensity, n = 7; contrast enhancement, n = 10). Univariate analysis showed that deep remission was associated with the absence of rectal involvement and the absence of switch of anti-TNF-α treatment or surgery requirement. Multivariate analysis demonstrated that only the absence of rectal involvement (OR = 4.6; 95%CI: 1.03-20.5) was associated with deep remission.Deep remission is achieved in approximately one third of patients on maintenance anti-TNF-α therapy. Absence of rectal involvement is predictive of deep remission.

Project description:ObjectivesMagnetic resonance enterography (MRE) interpretation of Crohn's disease (CD) is subjective and uses 2D analysis. We evaluated the feasibility of volumetric measurement of terminal ileal CD on MRE compared to endoscopy and sMARIA, and the responsiveness of volumetric changes to biologics.MethodsCD patients with MRE and contemporaneous CD endoscopic index of severity-scored ileocolonoscopy were included. A centreline was placed through the terminal ileum (TI) lumen defining the diseased bowel length on the T2-weighted non-fat saturated sequence, used by two radiologists to independently segment the bowel wall to measure volume (phase 1). In phase 2, we measured disease volume in patients treated with biologics, who had undergone pre- and post-treatment MRE, with treatment response classified via global physician assessment.ResultsPhase 1 comprised 30 patients (median age 29 (IQR 24, 34) years). Phase 2 included 12 patients (25 years (22, 38)). In phase 1, the mean of the radiologist-measured volumes was used for analysis. The median disease volume in those with endoscopically active CD was 20.9 cm3 (IQR 11.3, 44.0) compared to 5.7 cm3 (2.9, 9.8) with normal endoscopy. The mean difference in disease volume between the radiologists was 3.0 cm3 (limits of agreement -21.8, 15.9). The median disease volume of patients with active CD by sMARIA was 15.0 cm3 (8.7, 44.0) compared to 2.85 cm3 (2.6, 3.1) for those with inactive CD. Pre- and post-treatment median disease volumes were 28.5 cm3 (26.4, 31.2), 11 cm3 (4.8, 16.6), respectively in biological responders, vs 26.8 cm3 (12.3, 48.7), 40.1 cm3 (10, 56.7) in non-responders.ConclusionVolumetric measurement of terminal ileal CD by MRE is feasible, related to endoscopy and sMARIA activity, and responsive to biologics.Clinical relevance statementMeasuring the whole volume of diseased bowel on MRE in CD is feasible, related to how biologically active the disease is when assessed by endoscopy and by existing MRE activity scores, and is sensitive to treatment response.Key pointsMRE reporting for CD is subjective and uses 2D images rather than assessing the full disease volume. Volumetric measurement of CD relates to endoscopic activity and shows reduced disease volumes in treatment responders. This technique is an objective biomarker that can assess disease activity and treatment response, warranting validation.

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Project description:BackgroundDeep learning (DL)-based adipose tissue segmentation methods have shown great performance and efficacy for adipose tissue distribution analysis using magnetic resonance (MR) images, an important indicator of metabolic health and disease. The aim of this study was to evaluate the reproducibility of whole-body adipose tissue distribution analysis using proton density fat fraction (PDFF) images at different MR strengths.MethodsA total of 24 volunteers were imaged using both 1.5 and 3.0 T clinical MR imaging (MRI) scanners at two sites. Whole-body PDFF images were acquired covering from neck to knee, and grouped into three subparts: thorax, abdomen, and thigh. The PDFF images were then segmented automatically into subcutaneous adipose tissue (SAT) and internal adipose tissue (IAT) using a U-Net DL model. The volumes of whole body (WH), total adipose tissue (TAT), SAT, and IAT for total body and each subpart were measured, and the volume ratio of TAT/WH, SAT/WH, IAT/WH, SAT/TAT, and IAT/SAT were also calculated. Additionally, the reproducibility of PDFF values of SAT and IAT for total body and subparts were evaluated.ResultsThe intraclass correlation coefficient (ICC) and Pearson correlation coefficient of these volumes and volume ratios in whole-body between the two scanners were very close to one. The paired t-test and Bland-Altman plots for all comparisons showed no significant differences (P>0.05) when comparing the results from the 1.5 T scanner minus those from the 3.0 T scanner. The mean bias for WH, TAT, SAT, and IAT was -6.89 cm3 (P=0.95), -67.21 cm3 (P=0.40), 19.31 cm3 (P=0.74), and -18.84 cm3 (P=0.69), respectively. Good reproducibility performances were also found in each subpart, except for the indices of IAT volume, TAT/WH ratio, and SAT/TAT ratio in the thorax due to different susceptibility effects across MR strengths. The results also demonstrated good reproducibility between PDFF values of the two scanners with the mean bias for WH, thorax, abdomen, and thigh being -0.19% (P=0.219), -0.30% (P=0.118), 0.086% (P=0.494), and 0.24% (P=0.186) for SAT, respectively, as well as 0.35% (P=0.136), 0.46% (P=0.150), 0.58% (P=0.255), and 0.40% (P=0.169) for IAT, respectively.ConclusionsGood reproducibility of whole-body adipose tissue distribution analysis using the DL method between 1.5 and 3.0 T MR images was demonstrated, which may facilitate the whole-body adipose tissue distribution analysis using the quantitative MR-PDFF images.

Dataset Information

Quantitative Magnetic Resonance Imaging in Perianal Crohn's Disease at 1.5 and 3.0 T: A Feasibility Study.

Publications

Quantitative Magnetic Resonance Imaging in Perianal Crohn's Disease at 1.5 and 3.0 T: A Feasibility Study.

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