Changes in dynamic contrast-enhanced pharmacokinetic and diffusion-weighted imaging parameters reflect response to anti-TNF therapy in Crohn's disease

Bhatnagar, Gauraang; Δικαίος, Νικόλαος; Prezzi, Davide; Vega, Roser; Halligan, Steve; Taylor, Stuart A.

doi:10.1259/bjr.20150547

Cited by 23 publications

(10 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Quantification using the ADC may have value as a biomarker of CD activity and has shown innovative promise [61,[70][71][72]. In some studies [53,58,62] an ADC threshold value between 1.2 x 10 -3 and 2.4 x 10 -3 s/mm 2 was calculated to discriminate between active and non-active disease.…”

Section: Diffusion-weighted Imaging Scores (Dwi-maria Score or Clermomentioning

confidence: 99%

Assessment of Crohn’s Disease Activity: Magnetic Resonance Enterography in Comparison with Clinical and Endoscopic Evaluations

Minordi

Larosa

Papa

et al. 2019

JGLD

View full text Add to dashboard Cite

Crohn’s disease (CD) is a chronic inflammatory transmural disease of the gastrointestinal tract. The small bowel is the most frequently involved site. Assessment of the bowel is essential in guiding therapeutic decisions, medical or surgical therapy. Personalized medicine is a new concept that has the potential to improve therapeutic efficacy, reduce the risk of drug adverse events, and decrease costs if the therapy is the most suitable treatment for selected patients. Many techniques have been verified and standardised for small bowel CD. Among radiological techniques, CT enterography (CTE) and MRI-enterography (MRE) are the most widely accepted techniques, although MRI is generally preferable as it avoids radiation. In this review, we will present the current role and new innovative technological perspectives of MR enterography in comparison with clinical and endoscopic evaluations for the assessment of CD activity in adult patients. In particular, many studies have been performed to validate MRE signs such as biomarkers of active Crohn’s disease (such as mural thickening, mural T2 hyperintense signal, target sign, comb sign, ulceration and extramural mesenteric signs) and to select the most appropriate index for identifying active disease or severe inflammation (such as MaRIA score, Clermont index, and others). We conclude that MRE is a minimally invasive tool for the evaluation of disease activity and shows a very good correlation with the presence and severity of endoscopic lesions, so to allow a personalized medicine in patients with CD.

show abstract

Section: Diffusion-weighted Imaging Scores (Dwi-maria Score or Clermomentioning

confidence: 99%

Assessment of Crohn’s Disease Activity: Magnetic Resonance Enterography in Comparison with Clinical and Endoscopic Evaluations

Minordi

Larosa

Papa

et al. 2019

JGLD

View full text Add to dashboard Cite

show abstract

“…An early study on the efficacy of CD treatment was reported using MRI enhanced index and bowel thickness[ 21 ]. Other MRI evaluations, such as mucosal ulcer and ADC value, were used in recent studies[ 22 ]. Some studies[ 23 - 27 ] focused on the accuracy of MRI indicators for the evaluation of CD and the response to medical therapy.…”

Section: Discussionmentioning

confidence: 99%

Magnetic resonance imaging and Crohn’s disease endoscopic index of severity: Correlations and concordance

Zhu

Zhao

Miao

2018

WJG

View full text Add to dashboard Cite

AIMTo examine the correlation between magnetic resonance imaging (MRI) and endoscopic index of severity (CDEIS) in patients with Crohn’s disease (CD).METHODSThis was a retrospective study of 104 patients with CD that were treated at the Ruijin Hospital between March 2015 and May 2016. Among them, 61 patients with active CD were evaluated before/after treatment. MRI and endoscopy were performed within 7 d. CDEIS was evaluated. MRI parameters included MaRIA scores, total relative contrast enhancement (tRCE), arterial RCE (aRCE), portal RCE (pRCE), delay phase RCE (dRCE), and apparent diffusion coefficient. The correlation and concordance between multiple MRI findings and CDEIS changes before and after CD treatment were examined.RESULTSAmong the 104 patients, 61 patients were classified as active CD and 43 patients as inactive CD. Gender, age, disease duration, and disease location were not significantly different between the two groups (all P > 0.05). CRP levels were higher in the active group than in the inactive group (25.12 ± 4.12 vs 5.14 ± 0.98 mg/L, P < 0.001). Before treatment, the correlations between CDEIS and MaRIAs in all patients were r = 0.772 for tRCE, r = 0.754 for aRCE, r = 0.738 for pRCE, and r = 0.712 for dRCE (all MaRIAs, P < 0.001), followed by MRI single indexes. Among the active CD patients, 44 cases were remitted to inactive CD after treatment. The correlations between CDEIS and MaRIAs were r = 0.712 for aRCE, r = 0.705 for tRCE, r = 0.685 for pRCE, and r = 0.634 for dRCE (all MaRIAs, P < 0.001).CONCLUSIONArterial MaRIA should be an indicator for CD follow-up and dynamic assessment. CD treatment assessment was not completely concordant between CDEIS and MRI.

show abstract

“…Perfusion imaging with dynamic contrast enhanced-MR imaging is being examined in CD imaging with quantitative parameters to identify responders to anti-TNF-α medications. (69) Recent advances in MR imaging techniques may allow identification of a spectrum of inflammation versus fibrosis in CD lesions. (14) In a study MR scans of 41 patients who underwent elective bowel resection within 4 months before surgery,(14) using percentage of enhancement gain, MR was able to discriminate between mild-moderate and severe fibrosis deposition with a sensitivity of 0.94 and a specificity of 0.89.…”

Section: Future Directionsmentioning

confidence: 99%

Computed Tomography and Magnetic Resonance Enterography in Crohnʼs Disease

Deepak

Fletcher

Fidler

2016

Inflammatory Bowel Diseases

View full text Add to dashboard Cite

Early recognition of Crohn’s disease (CD) with initiation of disease modifying therapy has emerged as a prominent inflammatory bowel disease (IBD) management strategy. . Clinical practice and trials have often focused on patient symptoms, and more recently, serologic tests, stool inflammatory markers, and/or endoscopic inflammatory features for study entry criteria, treatment targets, disease activity monitoring, and to assess therapeutic response Unfortunately, patient symptoms do not correlate well with biologic disease activity, and endoscopy potentially misses or underestimates disease extent and severity in small bowel CD. Computed tomography enterography (CTE) and magnetic resonance enterography (MRE) are potential tools to identify and quantify transmural structural damage and disease activity in the small bowel. In this review, we discuss the role of CTE and MRE in disease management algorithms in clinical practice. We also compare the currently developed MRE based scoring systems, their strengths and pitfalls, as well as the role for MRE in clinical trials for CD.

show abstract

Changes in dynamic contrast-enhanced pharmacokinetic and diffusion-weighted imaging parameters reflect response to anti-TNF therapy in Crohn's disease

Abstract: DCE and DWI parameters change significantly in responders to TNF-α antagonists in CD, suggesting an effect on bowel wall vascularity.

Cited by 23 publications

References 27 publications

Assessment of Crohn’s Disease Activity: Magnetic Resonance Enterography in Comparison with Clinical and Endoscopic Evaluations

Assessment of Crohn’s Disease Activity: Magnetic Resonance Enterography in Comparison with Clinical and Endoscopic Evaluations

Magnetic resonance imaging and Crohn’s disease endoscopic index of severity: Correlations and concordance

Computed Tomography and Magnetic Resonance Enterography in Crohnʼs Disease

Contact Info

Product

Resources

About