A review of Magnetic Resonance Enterography classification and quantitative evaluation of active disease in patients with Crohn's disease

Minordi, Laura Maria; Larosa, Luigi; Papa, Alfredo; Cimino, Giovanni; Bevere, Antonio; Brizi, Maria Gabriella; Manfredi, Riccardo

doi:10.1016/j.clinimag.2020.06.006

Cited by 15 publications

(7 citation statements)

References 21 publications

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“…After scanning the stomach, MGCE still has enough battery power to record clear images of the entire small bowel ( Xie et al, 2019 ; Qian et al, 2018 ; Lai et al, 2020 ). MRE is preferred for pediatric CD patients because no ionizing radiation is involved, with high soft tissue contrast and a low incidence of adverse events (( Rimola et al, 2011 ; Hokama et al, 2020 ; Minordi et al, 2021 ).…”

Section: Discussionmentioning

confidence: 99%

“…Since MRE is radiation-free, it has been regarded as the technique of choice in the radiologic examination of the small bowel in pediatric patients. Currently, the magnetic resonance index of activity (MaRIA) is a widely recognized indicator for assessing small intestinal lesions by MRE in patients with Crohn’s disease ( Rimola et al, 2011 ; Hokama et al, 2020 ; Minordi et al, 2021 ). However, its sensitivity to detect superficial or small mucosal ulcerations is limited.…”

Section: Introductionmentioning

confidence: 99%

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Magnetically Guided Capsule Endoscopy and Magnetic Resonance Enterography in Children With Crohn’s Disease: Manifestations and the Value of Assessing Disease Activity

Zhao

et al. 2022

Front. Pharmacol.

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Objective: To investigate the value of magnetically guided capsule endoscopy (MGCE) and magnetic resonance enterography (MRE) in assessing the activity of pediatric Crohn’s disease.Methods: Clinical data from 82 subjects with pediatric Crohn’s disease, who underwent MGCE and MRE from October 2018 to March 2021 were analyzed retrospectively. Pairwise comparisons of several indexes, including MaRIA, CECDAI, PCDAI, and SES-CD, were performed by Spearman’s rank correlation test and kappa consistency analysis. CECDAI and MaRIA values predicted whether patients were moderately or severely active (PCDAI ≥30) clinically by logistic regression analysis. The area under the receiver operating characteristic curve (AUC) quantified the evaluation value of moderate to severe activity of pediatric CD.Results: In judging the severity of CD in the small intestine, the correlation coefficient between CECDAI and MaRIA was 0.406 (p < 0.05), and the kappa value of the consistency analysis was 0.299 (p < 0.05). MaRIA was weakly correlated with PCDAI (r = 0.254, p < 0.05), and they were weakly consistent in assessing the activity of Crohn’s disease (kappa = 0.135, p < 0.05). For predicting clinically moderate to severe activity, the fitted AUC based on CECDAI and MarRIA was 0.917, which was higher than applying a single parameter (CECDAI = 0.725, MarRIA = 0.899, respectively). MaRIA and serum albumin were significantly and negatively correlated (r = −1.064, p < 0.05). The consistency of the detection rate of gastric ulcers by MGCE and gastroscopy was moderate (kappa = 0.586, p < 0.05), and the detection rate of ulcers in the terminal ileum between MGCE and colonoscopy showed high consistency (kappa = 0.609, p < 0.05).Conclusions: MGCE and MRE are valuable, non-invasive methods for evaluating small bowel lesions in children with CD. The combined application of MGCE and MRE can better characterize the disease activity.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Magnetically Guided Capsule Endoscopy and Magnetic Resonance Enterography in Children With Crohn’s Disease: Manifestations and the Value of Assessing Disease Activity

Zhao

et al. 2022

Front. Pharmacol.

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“…CT enterography and MR enterography provide comparable diagnostic performances in patients with CD ( 60 ). Nevertheless, recent studies advise preferring MR enterography because of the absence of ionizing radiation, a very high soft-tissue contrast, and a lower incidence of adverse events ( 61 ). Although MRI and US are regarded as complementary methods in CD ( 59 ), most studies revealed superior accuracy of MRI for detecting the presence, extent, and activity of small bowel CD disease compared to US ( 62 ).…”

Section: Mrimentioning

confidence: 99%

Imaging Inflammation – From Whole Body Imaging to Cellular Resolution

et al. 2021

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Imaging techniques have evolved impressively lately, allowing whole new concepts like multimodal imaging, personal medicine, theranostic therapies, and molecular imaging to increase general awareness of possiblities of imaging to medicine field. Here, we have collected the selected (3D) imaging modalities and evaluated the recent findings on preclinical and clinical inflammation imaging. The focus has been on the feasibility of imaging to aid in inflammation precision medicine, and the key challenges and opportunities of the imaging modalities are presented. Some examples of the current usage in clinics/close to clinics have been brought out as an example. This review evaluates the future prospects of the imaging technologies for clinical applications in precision medicine from the pre-clinical development point of view.

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“…In this context, magnetic resonance enterography (MRE) has been developed as an alternative radiation-free imaging technique for CTE and has largely replaced CTE as the primary cross-sectional imaging modality for both adult and pediatric patients with CD. Although both CTE and MRE have demonstrated similar diagnostic abilities for diagnosing active inflammation of the bowel [ 3 , 4 ], MRE is often preferred to CTE because of the absence of ionizing radiation, very high soft tissue contrast, and lower incidence of adverse events [ 5 ]. Furthermore, MRE is the most validated imaging modality for disease evaluation and therapeutic monitoring in the research field [ 5 , 6 ]…”

Section: Introductionmentioning

confidence: 99%

“…Although both CTE and MRE have demonstrated similar diagnostic abilities for diagnosing active inflammation of the bowel [ 3 , 4 ], MRE is often preferred to CTE because of the absence of ionizing radiation, very high soft tissue contrast, and lower incidence of adverse events [ 5 ]. Furthermore, MRE is the most validated imaging modality for disease evaluation and therapeutic monitoring in the research field [ 5 , 6 ]…”

Section: Introductionmentioning

confidence: 99%

Comparison of Diagnostic Performance of Ultrasonography and Magnetic Resonance Enterography in the Assessment of Active Bowel Lesions in Patients with Crohn’s Disease: A Systematic Review and Meta-Analysis

et al. 2022

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We aimed to evaluate and compare the diagnostic performances of ultrasonography (US) and magnetic resonance enterography (MRE) in assessing active bowel lesions in patients with Crohn’s disease (CD). Materials and Methods: We searched PubMed and EMBASE for studies in which US and MRE were used to assess active bowel lesions in CD patients. Bivariate random effect meta-analytic methods were used to estimate pooled sensitivity, specificity, and hierarchical summary receiver operating characteristic (HSROC) curves. We performed a meta-regression analysis to explore the source of study heterogeneity. Results: Eleven studies involving 752 patients were included. US exhibited a pooled sensitivity of 86% (95% confidence interval (CI) 72–94), pooled specificity of 88% (95% CI 78–94), and HSROC of 0.93 in 10 studies. MRE exhibited a pooled sensitivity of 88% (95% CI 76–95), pooled specificity of 87% (95% CI 73–95), and an HSROC of 0.94 in eight studies. In seven studies comparing the diagnostic performances of US and MRE, the summary sensitivity of US and MRE were 86% (95% CI 65–96, I2 = 92.1) and 86% (95% CI 72–93, I2 = 88.1) (p = 0.841), respectively. The summary specificity of US and MRE were 87% (95% CI 78–93, I2 = 79.8%) and 84% (72–90, I2 = 72.5%) (p = 0.431), respectively, which showed no statistical differences. On meta-regression analysis, studies from Europe (p = 0.002), those that used linear US probes (p = 0.012), those on small bowel lesions (p = 0.01), and those with outcomes as combined features (active inflammation) reported higher US sensitivity than those from other regions, those that used both linear and convex US probes, those on small and large bowels, and those with outcome as one feature (bowel wall thickening or ulcer). Studies with pediatric patients (p = 0.001), those with reference standards including US (p = 0.001), and outcomes as combined features (p = 0.01) reported higher MRE specificity than those with adult populations, reference standards other than the US, and outcomes as one feature. Conclusions: In spite of considerable heterogeneity in the included studies, both US and MRE can diagnose active bowel lesions with comparable diagnostic accuracy in patients with CD. The study region, type of US probe, lesion location, investigated outcome for US sensitivity and study population, reference standards, and investigated outcomes for MRE specificity were potential sources of heterogeneity.

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A review of Magnetic Resonance Enterography classification and quantitative evaluation of active disease in patients with Crohn's disease

Cited by 15 publications

References 21 publications

Magnetically Guided Capsule Endoscopy and Magnetic Resonance Enterography in Children With Crohn’s Disease: Manifestations and the Value of Assessing Disease Activity

Magnetically Guided Capsule Endoscopy and Magnetic Resonance Enterography in Children With Crohn’s Disease: Manifestations and the Value of Assessing Disease Activity

Imaging Inflammation – From Whole Body Imaging to Cellular Resolution

Comparison of Diagnostic Performance of Ultrasonography and Magnetic Resonance Enterography in the Assessment of Active Bowel Lesions in Patients with Crohn’s Disease: A Systematic Review and Meta-Analysis

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