Reliability of Measuring Ileo-Colonic Disease Activity in Crohn’s Disease by Magnetic Resonance Enterography

Jairath, Vipul; Ordás, I; Zou, Guangyong; Panés, Julián; Stoker, Jaap; Taylor, Stuart A.; Santillan, Cynthia; Horsthuis, Karin; Samaan, Mark A; Shackelton, Lisa M.; Stitt, Larry; Hindryckx, Pieter; Khanna, Reena; Sandborn, William J.; D’Haens, Geert R.; Feagan, Brian G.; Levesque, Barrett G.; Rimola, Jordi

doi:10.1093/ibd/izx040

Cited by 55 publications

(45 citation statements)

References 33 publications

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“…The agreement between ultrasonographers for the presence of strictures was excellent [31]. Jairath et al [32] evaluated intra-and inter-observer variability between MRE scoring systems MaRIA and CDMI. This study reported "near-perfect" agreement for intra-observer reliability, but substantial agreement for inter-observer reliability.…”

Section: Resultsmentioning

confidence: 99%

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Underutilization of Bowel Ultrasound in North America in Children with Inflammatory Bowel Disease

Gamboa

Molle-Rios

Anupindi

2019

Dig Dis

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Background: Inflammatory bowel disease (IBD) is a chronic relapsing disease that requires evaluation using multiple objective tools. In Europe, bowel ultrasound (US) is a widely accepted modality used for the management of patients with IBD; however, its use in North America has only recently emerged as a potential technique. Objectives: Our goal was to identify current practice patterns of pediatric gastroenterologists and radiologists using bowel US in patients with IBD and highlight perceived limitations to the widespread adoption of this modality in North America. Methods: A 14-question survey was e-mailed to the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition internet bulletin board composed of 3,058 subscribers from 51 countries; the Society of Pediatric Radiology listserv composed of 1,917 subscribers worldwide; and the Society of Chairs of Radiology at Children's Hospitals listserv. Descriptive summary statistics was used. Results: In North America, about one-quarter of gastroenterology and radiology participants reported using bowel US for IBD; over 3-fourths expressed an interest in using US more often. Bowel US was performed more frequently for Crohn's disease. Both groups agreed the main limitation to using bowel US was concern for inter-observer variability and operator-dependent factors; radiologists reported that other modalities are more effective to assess IBD, whereas gastroenterologists reported unfamiliarity with bowel US indications and techniques. Conclusions: Our data show there is significant interest among both radiologists and gastroenterologists in using bowel US. However, lack of education, insufficient training, and perceived high inter-observer variability among US technologists are limitations preventing the widespread adoption of US for IBD in North America.

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Section: Resultsmentioning

confidence: 99%

“…They evaluate inter-observer variability of MRI utilizing the MaRIA and CDMI and show good reproducibility and moderate correlation with Crohn's disease index of severity. As seen with US, it is well known that there is variability of reporting among imaging modalities [32,33].…”

Section: Resultsmentioning

confidence: 99%

Underutilization of Bowel Ultrasound in North America in Children with Inflammatory Bowel Disease

Gamboa

Molle-Rios

Anupindi

2019

Dig Dis

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“…The MARIA is one of the best characterized MR-based indices for assessing disease activity and grading severity in patients with CD and has been proposed as a tool for monitoring disease activity in clinical practice and clinical trials. The index has proven to have a substantial intra-and interrater reliability, 23 but calculation of the index requires training, and measuring some components is timeconsuming, in particular RCE, which requires measurements in 3 regions of interest in each segment baseline and after administration of paramagnetic contrast. In addition to the MARIA, another 2 MR-based indices for the assessment of CD activity, the London 8 and the Clermont 13,14 indices have been formally derived.…”

Section: Discussionmentioning

confidence: 99%

“…In this sense, the MARIA has shown almost perfect intrarater reproducibility when centrally read supporting its use as a reliable tool in drug development trials. 23 In addition, in a clinical trial setting, the MARIA has demonstrated to be a feasible and reliable tool for measuring disease activity in patients with CD in a multicenter study, showing improved selection of patients with active inflammation over clinical indices and ileocolonoscopy. 12 In this scenario, MR-based patient selection has shown to increase a patient's safety profile by detecting extraluminal complications (ie, abscesses).…”

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confidence: 99%

Development and Validation of a Simplified Magnetic Resonance Index of Activity for Crohn’s Disease

et al. 2019

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“…A recent publication found moderate inter-observer agreement and substantial intra-observer agreement for the identification of creeping fat on MRE. 32 We did not quantify the amount of creeping fat because the curved multiplanar disposition of the fat depending on the disposition of the bowel is subject to inter-patient variability making it difficult to standardise its measurement. Our results lead us to hypothesise that creeping fat, muscular hypertrophy and fibrosis might be related to a poor response to TNF-α inhibitor treatment.…”

Section: Discussionmentioning

confidence: 99%

Pre‐treatment magnetic resonance enterography findings predict the response to TNF‐alpha inhibitors in Crohn's disease

Rimola

Fernández-Clotet

Capozzi

et al. 2020

Aliment Pharmacol Ther

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Background: Identifying predictors of therapeutic response is the cornerstone of personalised medicine. Aim: To identify predictors of long-term healing of severe inflammatory lesions based on magnetic resonance enterography (MRE) findings in patients with Crohn's disease (CD) treated with tumour necrosis factor alpha (TNF-α) inhibitors. Methods: This prospective longitudinal single-centre study included patients with clinically active CD requiring treatment with TNF-α inhibitors with at least one intestinal segment with a severe inflammatory lesion detected by MRE (segmental MaRIA ≥11). MRE data were obtained at baseline, and at weeks 14 and 46. The primary endpoint was healing of severe inflammatory lesions (MaRIA <11) in each segment. The secondary endpoint was healing of all severe inflammatory lesions on a per-patient analysis. Results: We included 58 patients with 86 intestinal segments with severe inflammatory lesions. At week 46, healing of severe lesions was found in 51/86 (59.3%) segments, and complete healing of inflammatory lesions in all segments was found in 28/58 (48.6%) patients. Multivariable analysis found baseline-negative predictors of long-term healing of severe inflammation were ileal (as opposed to colonic) loca

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Reliability of Measuring Ileo-Colonic Disease Activity in Crohn’s Disease by Magnetic Resonance Enterography

Abstract: "Substantial" interrater reliability was observed for all 3 indices. Future studies should assess responsiveness to treatment in order to confirm their utility as evaluative indices in clinical trials and clinical practice.

Cited by 55 publications

References 33 publications

Underutilization of Bowel Ultrasound in North America in Children with Inflammatory Bowel Disease

Underutilization of Bowel Ultrasound in North America in Children with Inflammatory Bowel Disease

Development and Validation of a Simplified Magnetic Resonance Index of Activity for Crohn’s Disease

Pre‐treatment magnetic resonance enterography findings predict the response to TNF‐alpha inhibitors in Crohn's disease

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