Diagnosis of postoperative recurrence of Crohn disease with MR-enterography: Value of diffusion-weighted imaging

Djelouah, Manel; Marical, Victoria; Kanagaratnam, Lukshe; Kianmanesh, Réza; Biron, A; Cadiot, Guillaume; Hoeffel, Christine

doi:10.1016/j.diii.2021.06.002

Cited by 10 publications

(4 citation statements)

References 30 publications

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“…Of 11 studies who reported the recurrence percentages for mRS and RS (reported or calculated), including 1497 patients, the difference in ER rates was calculated for ≥i2 versus ≥i2b. 19 , 21 , 27 , 34 , 35 , 39 , 44 , 45 , 51 , 59 , 64 In studies reporting ER defined as ≥i2, the weighted mean was 61.32% (95% CI, 60.61–62.03). The overall range was 39.1% to 84.7% (IQR, 47.0–69.6).…”

Section: Resultsmentioning

confidence: 99%

How Reliable Is Endoscopic Scoring of Postoperative Recurrence in Crohn Disease?: A Systematic Review and Meta-Analysis

van der Does de Willebois,

Bellato,

Duijvestein

et al. 2024

Annals of Surgery Open

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Objective: Guidelines advise to perform endoscopic surveillance following ileocolic resection (ICR) in Crohn disease (CD) for timely diagnosis of recurrence. This study aims to assess the variation in endoscopic recurrence (ER) rates in patients after ICR for CD using the most commonly used classification systems, the Rutgeerts score (RS) and modified Rutgeerts score (mRS) classifications. Methods: A systematic literature search using MEDLINE, Embase, and the Cochrane Library was performed. Randomized controlled trials and cohort studies describing ER < 12 months after an ICR for CD were included. Animal studies, reviews, case reports (<30 included patients), pediatric studies, and letters were excluded. The Newcastle–Ottawa Quality Assessment Scale and Cochrane Collaboration’s tool were used to assess risk of bias. Main outcome was the range of ER rates within 12 months postoperatively, defined as RS ≥ i2 and/or mRS ≥ i2b. A proportional meta-analysis was performed. The final search was performed on January 4, 2022. The study was registered at PROSPERO, CRD42022363208. Results: Seventy-six studies comprising 7751 patients were included. The weighted mean of ER rates in all included studies was 44.0% (95% confidence interval, 43.56–44.43). The overall range was 5.0% to 93.0% [interquartile range (IQR), 29.2–59.0]. The weighted means for RS and mRS were 44.0% and 41.1%, respectively. The variation in ER rates for RS and mRS were 5.0% to 93.0% (IQR, 29.0–59.5) and 19.8% to 62.9% (IQR, 37.3–46.5), respectively. Within studies reporting both RS and mRS, the weighted means for ER were 61.3% and 40.6%, respectively. Conclusions: This study demonstrates a major variation in ER rates after ICR for CD, suggesting a high likelihood of inadequate diagnosis of disease recurrence, with potentially impact on quality of life and health care consumption. Therefore, there is an important need to improve endoscopic scoring of recurrent disease.

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Section: Resultsmentioning

confidence: 99%

How Reliable Is Endoscopic Scoring of Postoperative Recurrence in Crohn Disease?: A Systematic Review and Meta-Analysis

van der Does de Willebois,

Bellato,

Duijvestein

et al. 2024

Annals of Surgery Open

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“… Mi decreases in active disease and can be a diagnostic marker with medium accuracy. Djelouah, 2021 [59] combined DWI and T2w (HASTE - trueFISP) ileocolonoscopy ileum and terminal ileum postoperative recurrence of active inflammation adult T2+DWI: 70% Sems, 95% Spec. 0.89 AUC.…”

Section: Resultsmentioning

confidence: 99%

Role of abbreviated non-contrast-enhanced MR-enterography in the evaluation of Crohn's disease activity and complications as an alternative for full protocol contrast-enhanced study: A systematic review and meta-analysis

Jannatdoust

Valizadeh

Razaghi

et al. 2023

Research in Diagnostic and Interventional Imaging

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“…72 In addition, a recent study found that diffusion-weighted MRE also had similar diagnostic ability compared with contrast-enhanced MRE to detect postoperative recurrence in CD patients. 73 The first MRE index MONITOR (Magnetic Resonance Imaging in CD to Predict Postoperative Recurrence) designed specifically for the prediction of postoperative recurrence by considering the Rutgeerts score as the gold standard and including the seven items, wall thickening, T2 signal increase, ulcers, contrast enhancement, diffusion-weighted signal increase, edema, and length of the diseased segment, 74 has been recently proposed. Using the best cutoff of ⩾1 point, the AUROC of the MONITOR index was 0.80 with a sensitivity of 79%, a specificity of 55% and predictive positive and negative values of 68% to predict endoscopic postoperative recurrence (Rutgeerts score > i1).…”

Section: Detection Of Postoperative Recurrence In CDmentioning

confidence: 99%

Use of imaging modalities for decision-making in inflammatory bowel disease

Nancey

Fuméry

Faure

et al. 2023

Therap Adv Gastroenterol

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Cross-sectional magnetic resonance enterography (MRE) and intestinal ultrasonography (IUS) provide valuable and noninvasive information to accurately assess disease activity, severity, and extent; detect complications; and monitor the response to treatment, as well as predict the postoperative recurrence of Crohn’s disease and a negative disease course. Therefore, both imaging modalities are emerging as pivotal diagnostic tools to achieve the emerging therapeutic target of transmural healing associated with better disease outcomes. Despite its numerous potential advantages over endoscopy and even MRE and its good availability, IUS is still widely underused to monitor and manage inflammatory bowel disease (IBD) patients and help in making clinical decisions in routine practice. This situation is clearly due to the absence of validated, reliable, and responsive indices, as well as the lack of trained gastroenterologists and radiologists, as IUS is a component of radiologist expertise in several countries but not yet integrated into the training program of gastroenterologists. However, there is an increasing body of evidence in the literature that IUS and MRE are both becoming essential imaging resources to help clinicians in making reliable decisions. Here, we discuss the up-to-date evidence about the usefulness and performance of cross-sectional imaging, focusing on the ability of bowel US and MRE to aid clinical decision-making for the optimal management and monitoring of IBD.

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Diagnosis of postoperative recurrence of Crohn disease with MR-enterography: Value of diffusion-weighted imaging

Cited by 10 publications

References 30 publications

How Reliable Is Endoscopic Scoring of Postoperative Recurrence in Crohn Disease?: A Systematic Review and Meta-Analysis

How Reliable Is Endoscopic Scoring of Postoperative Recurrence in Crohn Disease?: A Systematic Review and Meta-Analysis

Role of abbreviated non-contrast-enhanced MR-enterography in the evaluation of Crohn's disease activity and complications as an alternative for full protocol contrast-enhanced study: A systematic review and meta-analysis

Use of imaging modalities for decision-making in inflammatory bowel disease

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