Computed Tomography and Magnetic Resonance Enterography in Crohnʼs Disease

Deepak, Parakkal; Fletcher, Joel G.; Fidler, Jeff L.

doi:10.1097/mib.0000000000000845

Cited by 37 publications

(12 citation statements)

References 76 publications

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“…Benefits and limits of CTE, MRE and US have been extensively presented in recent reviews[ 53 , 55 - 61 ], systematic reviews and meta-analyses[ 52 , 62 ], and consensus guidelines[ 53 , 63 - 65 ]; therefore, they are beyond the scope of this review. Validated CSI scores to quantify activity in CD are mainly based on MRE[ 55 , 56 , 58 ]. A comparison between the three most used scores in adults with CD - Magnetic Resonance Index of Activity (MaRIA)[ 16 , 66 ], Clermont[ 67 ] and London[ 68 ] - was recently published[ 69 ].…”

Section: Discussionmentioning

confidence: 99%

Treat-to-target in Crohn’s disease: Will transmural healing become a therapeutic endpoint?

Serban

2018

WJCC

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Crohn’s disease (CD) represents a chronic transmural inflammatory condition of the gastrointestinal tract, which usually leads to structural damage and significant disability. Deep remission - defined by both clinical and endoscopic remission, signifying mucosal healing - represents the current endpoint in the treat-to-target strategy, significantly improving patients’ long-term outcomes. Transmural healing (TH) could be a more effective target, but this possibility remains unclear. This narrative review aims to critically review and summarize the available literature relating TH to long-term outcomes, being the first of its kind and to the best of the author’s knowledge. A systematic literature search (from inception to March 31 2018) was performed, using multiple databases, and identifying seven full-text manuscripts. In those studies, long-term favorable outcomes (≥ 52 wk) included sustained clinical remission, as well as fewer therapeutic changes, CD-related hospitalizations, and surgeries. Despite heterogeneous design and methodological limitations, six of the studies demonstrated that TH or intestinal healing (TH plus mucosal healing) were predictive for the aforementioned favorable outcomes. Therefore, TH may become a reasonable therapeutic target and be included in the concept of deep remission. Further prospective, well-designed, multicenter trials aiming to better define the role of TH in personalized therapy for CD and to determine the long-term influence of TH on bowel damage and disability are warranted.

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Section: Discussionmentioning

confidence: 99%

Treat-to-target in Crohn’s disease: Will transmural healing become a therapeutic endpoint?

Serban

2018

WJCC

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“…CSI, in particular, is a useful tool to assess response to therapy and monitor disease progression. However, its capability to predict adverse outcomes is less well established[ 34 , 35 ]. The MRE method provides information on disease activity in the small intestine and colon in just one exam, and it also establishes the diagnosis of penetrating complications, including fistulas and abscesses, which may be difficult to identify clinically.…”

Section: Cross-sectional Imaging For Disease Activity Monitoringmentioning

confidence: 99%

Assessment of disease activity in inflammatory bowel diseases: Non-invasive biomarkers and endoscopic scores

Rodrigues

Mazzaro

Nagasako

et al. 2020

WJGE

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Inflammatory bowel diseases (IBD) comprise two major forms: Crohn’s disease and ulcerative colitis. The diagnosis of IBD is based on clinical symptoms combined with results found in endoscopic and radiological examinations. In addition, the discovery of biomarkers has significantly improved the diagnosis and management of IBD. Several potential genetic, serological, fecal, microbial, histological and immunological biomarkers have been proposed for IBD, and they have been evaluated for clinical routine and clinical trials. Ileocolonoscopy, especially with biopsy collection, has been considered the standard method to diagnose IBD and to assess clinical activity of the disease, but it is limited to the colon and terminal ileum and is considered invasive. For this reason, non-invasive biomarkers are necessary for this type of chronic inflammatory disease, which affects mostly young individuals, as they are expected to have a long follow-up.

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“…Significant improvement in ultrasonographic parameters after treatment in patients with CD have been reported in prospective studies; however, correlation between ultrasound findings and clinical and biological response was variable 150151. Cross-sectional imaging with CT or MRI can be used to quantify transmural structural damage and disease activity, particularly in the small bowel, and are also able to detect obstructive and penetrating complications 152. Several MR-based scoring systems have been evaluated for assessing CD, including the Magnetic Resonance Index of Activity score, the Crohn's Disease MRI Index, the Magnetic Resonance Enterography Global Score, and the Nancy score 153154155156.…”

Section: Monitoringmentioning

confidence: 99%

“…Several MR-based scoring systems have been evaluated for assessing CD, including the Magnetic Resonance Index of Activity score, the Crohn's Disease MRI Index, the Magnetic Resonance Enterography Global Score, and the Nancy score 153154155156. Studies have shown significant correlation between MRI indexes and inflammatory parameters during treatment; however, MRI scoring is time-consuming, which may limit its use in routine clinical practice 74152…”

Section: Monitoringmentioning

confidence: 99%

“… 150 151 Cross-sectional imaging with CT or MRI can be used to quantify transmural structural damage and disease activity, particularly in the small bowel, and are also able to detect obstructive and penetrating complications. 152 Several MR-based scoring systems have been evaluated for assessing CD, including the Magnetic Resonance Index of Activity score, the Crohn's Disease MRI Index, the Magnetic Resonance Enterography Global Score, and the Nancy score. 153 154 155 156 Studies have shown significant correlation between MRI indexes and inflammatory parameters during treatment; however, MRI scoring is time-consuming, which may limit its use in routine clinical practice.…”

Section: Monitoringmentioning

confidence: 99%

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Management of Crohn's disease in Taiwan: consensus guideline of the Taiwan Society of Inflammatory Bowel Disease

et al. 2017

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Crohn's disease (CD) is a chronic relapsing and remitting inflammatory disease of the gastrointestinal tract. CD is rare in Taiwan and other Asian countries, but its prevalence and incidence have been steadily increasing. A steering committee was established by the Taiwan Society of Inflammatory Bowel Disease to formulate statements on the diagnosis and management of CD taking into account currently available evidence and the expert opinion of the committee. Thorough clinical, endoscopic, and histological assessments are required for accurate diagnosis of CD. Computed tomography and magnetic resonance imaging are complementary to endoscopic evaluation for disease staging and detecting complications. The goals of CD management are to induce and maintain remission, reduce the risk of complications, and improve quality of life. Corticosteroids are the mainstay for inducing re-mission. Immunomodulating and biologic therapies should be used to maintain remission. Patients should be evaluated for hepatitis B virus and tuberculosis infection prior to treatment and receive regular surveillance for cancer. These consensus statements are based on current local evidence with consideration of factors, and could be serve as concise and practical guidelines for supporting clinicians in the management of patients with CD in Taiwan.

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Computed Tomography and Magnetic Resonance Enterography in Crohnʼs Disease

Cited by 37 publications

References 76 publications

Treat-to-target in Crohn’s disease: Will transmural healing become a therapeutic endpoint?

Treat-to-target in Crohn’s disease: Will transmural healing become a therapeutic endpoint?

Assessment of disease activity in inflammatory bowel diseases: Non-invasive biomarkers and endoscopic scores

Management of Crohn's disease in Taiwan: consensus guideline of the Taiwan Society of Inflammatory Bowel Disease

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