New magnetic resonance imaging sequences for fibrosis assessment in Crohn’s disease: a pilot study

Caron, Bénédicte; Laurent, V.; Odille, Freddy; Danese, Silvio; Hossu, G.; Peyrin–Biroulet, Laurent

doi:10.1080/00365521.2022.2094727

Cited by 4 publications

(3 citation statements)

References 14 publications

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“…26 New MRE sequences, including the perfusion fraction (intravoxel incoherent motion used to estimate blood flow in tissues), T1 mapping sequence, and reduction of relaxation time, have been recently associated with fibrosis in a prospective, single-center cohort study including 33 CD patients. 27 In clinical practice, the association of IUS examination and Doppler with SICUS or CEUS or MRE with such novel sequences may increase the accuracy in detecting and better quantifying transmural intestinal fibrosis.…”

Section: Diagnostic Accuracy For Determining the Degree Of Intestinal...mentioning

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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Section: Diagnostic Accuracy For Determining the Degree Of Intestinal...mentioning

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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“…While some imaging techniques have been intensively investigated through the last decade, mainly ultrasound elastography [ 93 , 94 , 95 ] and specific magnetic resonance techniques, such as diffusion-weighted imaging (DWI) [ 96 , 97 , 98 , 99 , 100 , 101 ], diffusion kurtosis imaging (DKI) [ 102 , 103 ], magnetization transfer (MT) [ 104 , 105 , 106 , 107 , 108 , 109 ], and intravoxel incoherent motion imaging (IVIM) [ 110 , 111 ], none has been definitively established as reliable for this objective [ 112 , 113 ]. Very recently, some promising developments arose through artificial intelligence (AI) techniques in cross-sectional imaging, such as radiomics [ 114 , 115 , 116 , 117 ].…”

Section: Non-invasive Techniques To Access Fibrosismentioning

confidence: 99%

“…It is recommended that such CSI techniques as ultrasonography (US), computed tomography (CT), enterography (CTE), or magnetic resonance (MR) enterography (MRE) should be performed at the time of diagnosis of CD to complement endoscopy by assessing stricturing and penetrating complications [110,[125][126][127][128][129]. These techniques are all able to detect strictures with high accuracy, with the selection of the best approach depending Diagnostics 2023, 13, 2188 9 of 24 on availability, cost, patient clinical status (including comorbidities), and radiation concerns [124].…”

Section: Cross-sectional Imagingmentioning

confidence: 99%

How to Evaluate Fibrosis in IBD?

Sousa

Magro

2023

Diagnostics

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In this review, we will describe the importance of fibrosis in inflammatory bowel disease (IBD) by discussing its distinct impact on Crohn’s disease (CD) and ulcerative colitis (UC) through their translation to histopathology. We will address the existing knowledge on the correlation between inflammation and fibrosis and the still not fully explained inflammation-independent fibrogenesis. Finally, we will compile and discuss the recent advances in the noninvasive assessment of intestinal fibrosis, including imaging and biomarkers. Based on the available data, none of the available cross-sectional imaging (CSI) techniques has proved to be capable of measuring CD fibrosis accurately, with MRE showing the most promising performance along with elastography. Very recent research with radiomics showed encouraging results, but further validation with reliable radiomic biomarkers is warranted. Despite the interesting results with micro-RNAs, further advances on the topic of fibrosis biomarkers depend on the development of robust clinical trials based on solid and validated endpoints. We conclude that it seems very likely that radiomics and AI will participate in the future non-invasive fibrosis assessment by CSI techniques in IBD. However, as of today, surgical pathology remains the gold standard for the diagnosis and quantification of intestinal fibrosis in IBD.

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Endoskopische und chirurgische Behandlung intestinaler Stenosen im Zusammenhang mit chronisch-entzündlichen Darmerkrankungen

Pfister,

Zbinden,

Misselwitz

et al. 2024

Schweiz. Gastroenterol.

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ZusammenfassungDer Morbus Crohn (MC), eine chronisch-entzündliche Darmerkrankung (CED), ist durch eine übergreifende transmurale Entzündung des Gastrointestinaltrakts gekennzeichnet, die zu entzündlichen und fibrotischen Stenosen führen kann. Bei etwa 20 % der Patient:innen mit einem MC werden innerhalb von 10 Jahren nach Diagnosestellung Stenosen beobachtet. Mithilfe der MR-Enteroklyse, welche neben der Abdomensonographie die Diagnostik der Wahl darstellt, kann eine CED-assoziierte Stenose optimal bezüglich Anatomie und assoziierter Komplikationen beurteilt werden. Bei rund 40–80 % dieser Patient:innen ist eine chirurgische Behandlung (Resektion oder Strikturoplastik) innerhalb von 10 Jahren nach der Diagnosestellung erforderlich. Daher ist eine frühzeitige und anhaltende interdisziplinäre Zusammenarbeit zwischen Gastroenterologie, interventioneller Endoskopie, Radiologie und Viszeralchirurgie von entscheidender Bedeutung bei der Behandlung von CED-assoziierten Stenosen. Die endoskopische Ballondilatation (EBD) zeigt bei Stenosen mit hierfür günstigen Voraussetzungen (z. B. kurzstreckig, d. h. < 5 cm, isoliert und/oder postoperativ = Anastomosenstenose ohne assoziierte Komplikationen, wie z. B. Abszess, Fistel oder Malignität) gute Ergebnisse in Bezug auf Sicherheit, kurz- und langfristige Wirksamkeit und Patient:innenzufriedenheit. Mithilfe dieser endoskopischen Intervention kann in solchen Fällen eine Operation verzögert oder verhindert werden. Schliesslich ist eine individuelle Herangehensweise je nach Krankheitsaktivität, Stenosenanatomie und -merkmalen sowie Patient:innenwunsch in enger interdisziplinärer Abstimmung und gemeinsamer Betreuung durch Gastroenterologie, interventionelle Endoskopie, Radiologie und Viszeralchirurgie essenziell für die bestmögliche Betreuung dieser Patient:innen.

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New magnetic resonance imaging sequences for fibrosis assessment in Crohn’s disease: a pilot study

Cited by 4 publications

References 14 publications

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

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

How to Evaluate Fibrosis in IBD?

Endoskopische und chirurgische Behandlung intestinaler Stenosen im Zusammenhang mit chronisch-entzündlichen Darmerkrankungen

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