Quantitative apparent diffusion coefficient (ADC) values as an imaging biomarker for fibrosis in pediatric Crohn’s disease: preliminary experience

Kovanlıkaya, Arzu; Beneck, Debra; Rose, Melissa; Renjen, Pooja; Dunning, Allison; Solomon, Aliza; Brill, Paula W.

doi:10.1007/s00261-014-0247-1

Cited by 31 publications

(9 citation statements)

References 18 publications

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“…Oto et al 12 in a study of 18 patients reported ADC values (calculated by monoexponential signal decay) were significantly different in inflamed vs non-inflamed terminal ileum. Kovanlikaya et al 22 reported on a small cohort of five patients who underwent surgical resection. They demonstrated significant differences in ADC values between strictures and inflamed, non-stenotic segments as well as between normal and diseased bowel segments.…”

Section: Discussionmentioning

confidence: 99%

“…For quantification of DWI parameters, monoexponential apparent diffusion coefficient (ADC) parameters were generated using all five b-values, and fits of low (0, 50 and 100 s mm 22 ) and high (300 and 600 s mm 22 ) were performed to separate fast (ADC fast ) and slow (ADC slow ) diffusion components. To account for multiexponential DWI signal decay due to microcapillary perfusion, the stretched exponential model 17 was employed where the ADC (ADC SE ) and heterogeneity index (a) were quantified.…”

Section: Dynamic Contrast-enhanced and Diffusion-weighted Imaging Anamentioning

confidence: 99%

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

Bhatnagar

Δικαίος

Prezzi³

et al. 2015

BJR

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Section: Discussionmentioning

confidence: 99%

Section: Dynamic Contrast-enhanced and Diffusion-weighted Imaging Anamentioning

confidence: 99%

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

Bhatnagar

Δικαίος

Prezzi³

et al. 2015

BJR

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“…A study of 5 pediatric patients with CD showed that ADC values were high in normal segments, moderate in segments with acute inflammation, and low in the presence of fibrosis. 47 There was a progressive decrease in ADC values during the clinical course. A longitudinal observation of 13 pediatric patients showed that ADC values changed with disease course.…”

Section: New Techniquesmentioning

confidence: 94%

Magnetic resonance enterography for the evaluation of the deep small intestine in Crohn's disease

et al. 2016

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For the control of Crohn's disease (CD) a thorough assessment of the small intestine is essential; several modalities may be utilized, with cross-sectional imaging being important. Magnetic resonance (MR) enterography, i.e., MRE is recommended as a modality with the highest accuracy for CD lesions. MRE and MR enteroclysis are the two methods performed following distension of the small intestine. MRE has sensitivity and specificity comparable to computed tomography enterography (CTE); although images obtained using MRE are less clear compared with CTE, MRE does not expose the patient to radiation and is superior for soft-tissue contrast. Furthermore, it can assess not only static but also dynamic and functional imaging and reveals signs of CD, such as abscess, comb sign, fat edema, fistula, lymph node enhancement, less motility, mucosal lesions, stricture, and wall enhancement. Several indices of inflammatory changes and intestinal damage have been proposed for objective evaluation. Recently, diffusion-weighted imaging has been proposed, which does not need bowel preparation and contrast enhancement. Comprehension of the characteristics of MRE and other modalities is important for better management of CD.

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“…36 Fourth, the b-value of standard ssDWI was adapted to 500 s/mm 2 to fit the SNR limitation of MUSE-DWI at high-resolution acquisition, although the use of b-value of 500 s/mm 2 was also included in a few studies for detecting CD. 9,37,38 The reduced b-value might help maintain wall signal for small intestines that could provide clear anatomical details for disease localization, however at the expense of sacrificing lesion contrast. 34 Further comparative studies on the optimal choice of b-value for CD diagnosis are thus needed.…”

Section: Limitationsmentioning

confidence: 99%

Multi‐shot Diffusion‐Weighted MRI With Multiplexed Sensitivity Encoding (MUSE) in the Assessment of Active Inflammation in Crohn's Disease

Chang

Chen

Chung

et al. 2021

Magnetic Resonance Imaging

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Background Single‐shot diffusion‐weighted imaging (ssDWI) has been shown useful for detecting active bowel inflammation in Crohn's disease (CD) without MRI contrast. However, ssDWI suffers from geometric distortion and low spatial resolution. Purpose To compare conventional ssDWI with higher‐resolution ssDWI (HR‐ssDWI) and multi‐shot DWI based on multiplexed sensitivity encoding (MUSE‐DWI) for evaluating bowel inflammation in CD, using contrast‐enhanced MR imaging (CE‐MRI) as the reference standard. Study Type Prospective. Subjects Eighty nine patients with histological diagnosis of CD from previous endoscopy (55 male/34 female, age: 17–69 years). Field Strength/Sequences ssDWI (2.7 mm × 2.7 mm), HR‐ssDWI (1.8 mm × 1.8 mm), MUSE‐DWI (1.8 mm × 1.8 mm) based on echo‐planar imaging, T2‐weighted imaging, and CE‐MRI sequences, all at 1.5 T. Assessment Five raters independently evaluated the tissue texture conspicuity, geometry accuracy, minimization of artifacts, diagnostic confidence, and overall image quality using 5‐point Likert scales. The diagnostic performance (sensitivity, specificity and accuracy) of each DWI sequences was assessed on per‐bowel‐segment basis. Statistical Tests Inter‐rater agreement for qualitative evaluation of each parameter was measured by the intra‐class correlation coefficient (ICC). Paired Wilcoxon signed‐rank tests were performed to evaluate the statistical significance of differences in qualitative scoring between DWI sequences. A P value <0.05 was considered to be statistically significant. Results Tissue texture conspicuity, geometric distortions, and overall image quality were significantly better for MUSE‐DWI than for ssDWI and HR‐ssDWI with good agreement among five raters (ICC: 0.70–0.89). HR‐ssDWI showed significantly poorer performance to ssDWI and MUSE‐DWI for all qualitative scores and had the worst diagnostic performance (sensitivity of 57.0% and accuracy of 87.3%, with 36 undiagnosable cases due to severe artifacts). MUSE‐DWI showed significantly higher sensitivity (97.5% vs. 86.1%) and accuracy (98.9% vs. 95.1%) than ssDWI for detecting bowel inflammation. Data Conclusion MUSE‐DWI was advantageous in assessing bowel inflammation in CD, resulting in improved spatial resolution and image quality. Level of Evidence 2 Technical Efficacy Stage 2

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Quantitative apparent diffusion coefficient (ADC) values as an imaging biomarker for fibrosis in pediatric Crohn’s disease: preliminary experience

Cited by 31 publications

References 18 publications

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

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

Magnetic resonance enterography for the evaluation of the deep small intestine in Crohn's disease

Multi‐shot Diffusion‐Weighted MRI With Multiplexed Sensitivity Encoding (MUSE) in the Assessment of Active Inflammation in Crohn's Disease

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