Comparison of diagnostic performance between 1 millisievert CT enterography and half-standard dose CT enterography for evaluating active inflammation in patients with Crohn’s disease

Son, Jung Hee; Kim, Seung Ho; Cho, Een Young; Ryu, Kyu-Hyung

doi:10.1007/s00261-017-1359-1

Cited by 7 publications

(1 citation statement)

References 23 publications

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“…The lack of radiation exposure is a clear advantage of MRE in this setting, particularly given the regular repetitive nature of the evaluation. Although current computed tomography techniques allow for a remarkable reduction in the radiation dose for CTE, radiation exposure associated with CTE in patients with CD remains a concern [ 28 29 30 31 32 33 34 ]. We did not address the use of CTE alone in our study, as we judged that this strategy may not be as widely adopted as the use of MRE alone or mixed CTE and MRE, considering the amount of radiation exposure.…”

Section: Discussionmentioning

confidence: 99%

Is the Mixed Use of Magnetic Resonance Enterography and Computed Tomography Enterography Adequate for Routine Periodic Follow-Up of Bowel Inflammation in Patients with Crohn's Disease?

Son

Kang

et al. 2022

Korean J Radiol

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Objective Computed tomography enterography (CTE) and magnetic resonance enterography (MRE) are considered substitutes for each other for evaluating Crohn's disease (CD). However, the adequacy of mixing them for routine periodic follow-up for CD has not been established. This study aimed to compare MRE alone with the mixed use of CTE and MRE for the periodic follow-up of small bowel inflammation in patients with CD. Materials and Methods We retrospectively compared two non-randomized groups, each comprising 96 patients with CD. One group underwent CTE and MRE (MRE followed by CTE or vice versa) for the follow-up of CD (interval, 13–27 months [median, 22 months]), and the other group underwent MRE alone (interval, 15–26 months [median, 21 months]). However, these two groups were similar in clinical characteristics. Three independent readers from three different institutions determined whether inflammation had decreased, remained unchanged, or increased within the entire small bowel and the terminal ileum based on sequential enterography of the patients after appropriate blinding. We compared the two groups for inter-reader agreement and accuracy (terminal ileum only) using endoscopy as the reference standard for enterographic interpretation. Results The inter-reader agreement was greater in the MRE alone group for the entire small bowel (intraclass correlation coefficient [ICC]: 0.683 vs. 0.473; p = 0.005) and the terminal ileum (ICC: 0.656 vs. 0.490; p = 0.030). The interpretation accuracy was higher in the MRE alone group without statistical significance (70.9%–74.5% vs. 57.9%–64.9% in individual readers; adjusted odds ratio = 3.21; p = 0.077). Conclusion The mixed use of CTE and MRE was inferior to MRE alone in terms of inter-reader reliability and could probably be less accurate than MRE alone for routine monitoring of small bowel inflammation in patients with CD. Therefore, the consistent use of MRE is favored for this purpose.

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