A Preliminary Study on the Feasibility of the Quantitative Parameters of Dual-Energy Computed Tomography Enterography in the Assessment of the Activity of Intestinal Crohn’s Disease

Xiao, Weixiong; Zhu, Yuting; Zhang, Zhichao; Luo, Mingzhang; Ma, M.

doi:10.2147/ijgm.s331763

Cited by 8 publications

(9 citation statements)

References 9 publications

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“…λ HU represents the attenuation changes within the lesion during the passage of contrast agent. We found that λ HU -V and λ HU -A were significantly correlated with CD activity, consistent with previous studies [ 22 , 31 ], indicating that the amount of contrast agent increases as the blood vessels increase when CD is in the active phase. Our results show that λ HU -V had better diagnostic efficacy (AUC 0.81 vs 0.79) than λ HU -A, which is consistent with previous research results [ 31 , 32 ].…”

Section: Discussionsupporting

confidence: 92%

Establishing a machine learning model based on dual-energy CT enterography to evaluate Crohn’s disease activity

Li,

Xie,

Tang

et al. 2024

Insights Imaging

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Objectives The simplified endoscopic score of Crohn’s disease (SES-CD) is the gold standard for quantitatively evaluating Crohn’s disease (CD) activity but is invasive. This study aimed to develop and validate a machine learning (ML) model based on dual-energy CT enterography (DECTE) to noninvasively evaluate CD activity. Methods We evaluated the activity in 202 bowel segments of 46 CD patients according to the SES-CD score and divided the segments randomly into training set and testing set at a ratio of 7:3. Least absolute shrinkage and selection operator (LASSO) was used for feature selection, and three models based on significant parameters were established based on logistic regression. Model performance was evaluated using receiver operating characteristic (ROC), calibration, and clinical decision curves. Results There were 110 active and 92 inactive bowel segments. In univariate analysis, the slope of spectral curve in the venous phases (λHU-V) has the best diagnostic performance, with an area under the ROC curve (AUC) of 0.81 and an optimal threshold of 1.975. In the testing set, the AUC of the three models established by the 7 variables to differentiate CD activity was 0.81–0.87 (DeLong test p value was 0.071–0.766, p > 0.05), and the combined model had the highest AUC of 0.87 (95% confidence interval (CI): 0.779–0.959). Conclusions The ML model based the DECTE can feasibly evaluate CD activity, and DECTE parameters provide a quantitative analysis basis for evaluating specific bowel activities in CD patients. Critical relevance statement The machine learning model based on dual-energy computed tomography enterography can be used for evaluating Crohn’s disease activity noninvasively and quantitatively. Key Points Dual-energy CT parameters are related to Crohn’s disease activity. Three machine learning models effectively evaluated Crohn’s disease activity. Combined models based on conventional and dual-energy CT have the best performance. Graphical Abstract

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Section: Discussionsupporting

confidence: 92%

Establishing a machine learning model based on dual-energy CT enterography to evaluate Crohn’s disease activity

Li,

Xie,

Tang

et al. 2024

Insights Imaging

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“…These results could be explained by increased vascular permeability, congestion, and edema of the intestinal wall in the active stage of CD (27) and consequently increased iodine content of the examined tissues.…”

Section: Resultsmentioning

confidence: 97%

“…Two studies (28,30) focused on the general distinction between normal bowel segments and pathological ones without specifying the status of the lesions (active or in remission); four studies (26,29,32,33) investigated the differences between normal segments and segments with active inflammation; three studies (Kim et al (25), Xiao et al (27), Chen et al 31) focused particularly on the distinction of active versus remissive disease.…”

Section: Resultsmentioning

confidence: 99%

“…The outcome measure included NIC-V for all studies except studies by Kim et al (25) and Villanueva Campos et al (30), which only included IC-V, and Xiao et al (27), which included IC-V and IC-A. The main acquisition technique was dual source acquisition except the study by Kim et al (25), which used detector-based spectral separation.…”

Section: Resultsmentioning

confidence: 99%

“…Three of the included studies used the Crohn's disease activity index (CDAI) as the main reference (25)(26)(27), two studies used endoscopy, biochemistry, and clinical symptoms as reference (28,29), two other studies used routine CTE findings (30,31), one used the histopathologic score (32), and the last one used previous iodine density data (33) (Table 2).…”

Section: Quadasmentioning

confidence: 99%

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Application of multi-spectral CT imaging in Crohn's disease: a systematic review

et al. 2023

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Background No quantitative computed tomography (CT) biomarker is actually sufficiently accurate to assess Crohn’s disease (CD) lesion activity, with adequate precision to guide clinical decisions. Purpose To assess the available literature on the use of iodine concentration (IC), from multi-spectral CT acquisition, as a quantitative parameter able to distinguish healthy from affected bowel and assess CD bowel activity and heterogeneity of activity along the involved segments. Material and Methods A literature search was conducted to identify original research studies published up to February 2022. The inclusion criteria were original research papers (>10 human participants), English language publications, focus on dual-energy CT (DECT) of CD with iodine quantification (IQ) as an outcome measure. The exclusion criteria were animal-only studies, languages other than English, review articles, case reports, correspondence, and study populations <10 patients. Results Nine studies were included in this review; all of which showed a strong correlation between IC measurements and CD activity markers, such as CD activity index (CDAI), endoscopy findings and simple endoscopic score for Crohn's disease (SES-CD), and routine CT enterography (CTE) signs and histopathologic score. Statistically significant differences in IC were reported between affected bowel segments and healthy ones (higher P value was P < 0.001), normal segments and those with active inflammation ( P < 0.0001) as well as between patients with active disease and those in remission ( P < 0.001). Conclusion The mean normalized IC at DECTE could be a reliable tool in assisting radiologists in the diagnosis, classification and grading of CD activity.

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Prediction of pathological activity in Crohn’s disease based on dual-energy CT enterography

Zhou,

Chen,

et al. 2024

Abdom Radiol

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Purpose To explore the feasibility of predicting the pathological activity of Crohn’s disease (CD) based on dual-energy CT enterography (DECTE). Methods The clinical, endoscopic, imaging and pathological data of 55 patients with CD scanned by DECTE were retrospectively analyzed; the pathological results were used as a reference standard to classify the diseased bowel segments into active and inactive phases. The normalized iodine concentration (NIC), energy-spectrum curve slope K, dual energy index (DEI), fat fraction (FF) of the arterial phases and venous phases were compared. To assess the parameters’ predictive ability, receiver-operating characteristic curves were used. The Delong test was used to compare the differences between the diagnostic efficiency of each parameter. Results A total of 84 intestinal segments were included in the study, including 54 active intestinal segments and 30 inactive intestinal segments. The NIC, energy-spectrum curve slope K and DEI were significantly different between active and inactive bowel segments in the arterial and venous phases (P < 0.05), while FF were not significantly different (P > 0.05). The largest area under the curve (AUC) of NIC, energy-spectrum curve slope K and DEI were higher in arterial phase than in venous phase. For identifying the intestinal activity of CD, the maximum AUC of NIC in arterial phase was 0.908, with a sensitivity of 0.833 and a specificity of 0.800, and the DEI in arterial phase had the highest sensitivity (0.944). Conclusion The NIC, energy-spectrum curve slope K and DEI can effectively distinguish the active and inactive phases of the intestinal segments of CD patients and provide good assistance for determining further treatment. Graphical abstract

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A Preliminary Study on the Feasibility of the Quantitative Parameters of Dual-Energy Computed Tomography Enterography in the Assessment of the Activity of Intestinal Crohn’s Disease

Cited by 8 publications

References 9 publications

Establishing a machine learning model based on dual-energy CT enterography to evaluate Crohn’s disease activity

Establishing a machine learning model based on dual-energy CT enterography to evaluate Crohn’s disease activity

Application of multi-spectral CT imaging in Crohn's disease: a systematic review

Prediction of pathological activity in Crohn’s disease based on dual-energy CT enterography

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