US and MRI of gastrointestinal graft-versus-host disease

Mentzel, Hans‐Joachim; Kentouche, Karim; Kosmehl, Hartwig; Gruhn, Bemd; Vogt, S.; Sauerbrey, Axel; Behrendt, W.; Fuchs, D.; Zintl, F; Kaiser, Werner A.

doi:10.1007/s00247-001-0613-3

Cited by 21 publications

(10 citation statements)

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“…Magnetic resonance imaging-based studies currently consist only of case reports. 12,13 Basically, magnetic resonance imaging findings are reported to be nearly identical to the known CT features. Figure 1 Mean maximum signal increase is calculated by subtracting the baseline signal (dB during the first second of examination) from the maximum signal during the first 100 s recorded after i.v.…”

Section: Discussionmentioning

confidence: 77%

Transmural penetration of intravenously applied microbubbles during contrast-enhanced ultrasound as a new diagnostic feature in patients with GVHD of the bowel

Schreyer

Landfried

Zorger

et al. 2010

Bone Marrow Transplant

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GVHD is a common complication in patients after allo-SCT. Early detection is important because early therapy may improve the outcome. We evaluated contrastenhanced ultrasound (CEUS) in patients with GVHD to assess typical imaging features. CEUS was performed in nine patients with histologically proven GVHD. As a control four healthy volunteers and six patients with Crohn's disease (CD) were examined. We employed a high-resolution multi-frequency transducer (6-9 MHz) with contrast harmonic imaging. After the injection of 2.4 mL SonoVue (Bracco, Milan, Italy) intravenously data were acquired and stored digitally. Regions of interest were manually placed over the surrounding mesenteric fat, bowel wall and bowel lumen. Maximum signal increase of each compartment was calculated. Patients with CD and GVHD showed significant contrast uptake in the bowel wall. In contrast to CD patients and healthy volunteers, patients with GVHD showed transmural penetration of microbubbles into the bowel lumen. We assume that the damaged gut mucosal barrier in GVHD enables the microbubbles to penetrate through the bowel wall into the bowel lumen. The penetration of microbubbles into the bowel lumen may serve as a novel diagnostic feature for GVHD if confirmed in controlled clinical trials.

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Section: Discussionmentioning

confidence: 77%

Transmural penetration of intravenously applied microbubbles during contrast-enhanced ultrasound as a new diagnostic feature in patients with GVHD of the bowel

Schreyer

Landfried

Zorger

et al. 2010

Bone Marrow Transplant

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“…Work on diagnostic blood assays have identified biomarkers, but more work needs to be done to validate these in multicenter prospective studies prior to widespread clinical use (31). Moreover, while noninvasive conventional imaging has played a role in aGVHD management, the structural manifestations that are detectable often only present at the latest of disease stages (32,33). Molecular imaging of aGVHD, which may yield more sensitive detection, has been very limited, mostly focusing on PET imaging using [ 18 F]FDG (34), a non-specific tracer with high uptake in many cell types and conditions.…”

Section: Discussionmentioning

confidence: 99%

“…Several other imaging techniques have also shown promise for definitive diagnosis of aGVHD, particularly gastrointestinal manifestations of the disease, including magnetic resonance imaging (MRI), computed tomography (CT), high-resolution transabdominal ultrasound and color Doppler ultrasound (32,33). These techniques primarily focus on detection of edema and thickening of the intestinal wall during advanced stages of aGVHD, and are therefore likely limited for early disease detection.…”

Section: Discussionmentioning

confidence: 99%

A PET Imaging Strategy to Visualize Activated T Cells in Acute Graft-versus-Host Disease Elicited by Allogenic Hematopoietic Cell Transplant

et al. 2017

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A major barrier to successful use of allogeneic hematopoietic cell transplantation is acute graft-versus-host disease (aGVHD), a devastating condition that arises when donor T cells attack host tissues. With current technologies, aGVHD diagnosis is typically made after end-organ injury and often requires invasive tests and tissue biopsies. This impacts patient prognosis as treatments are dramatically less effective at late disease stages. Here we show that a novel positron emission tomography (PET) radiotracer, 2′-deoxy-2′-[18F]fluoro-9-β-D-arabinofuranosylguanine ([18F]F-AraG), targeted towards two salvage kinase pathways preferentially accumulates in activated primary T cells. [18F]F-AraG PET imaging of a murine aGVHD model enabled visualization of secondary lymphoid organs harboring activated donor T cells prior to clinical symptoms. Tracer biodistribution in healthy humans showed favorable kinetics. This new PET strategy has great potential for early aGVHD diagnosis, enabling timely treatments and improved patient outcomes. [18F]F-AraG may be useful for imaging activated T cells in various biomedical applications.

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“…In addition, they have not been validated for monitoring of treatment response of intestinal GVHD, but are suitable to detect pathological features of advanced intestinal GVHD such as thickening and edema of the intestinal wall. 48,49 Thus, they may be useful complementary diagnostic methods providing additional information particularly in advanced or treatment refractory stages of intestinal GVHD. 43,50,51 Our clinical results demonstrate that FDG-PET imaging can advance noninvasive diagnostic mapping and monitoring of intestinal GVHD and possibly allow early prognostic assessment of GVHD responsiveness to therapy.…”

Section: Discussionmentioning

confidence: 99%

Clinical molecular imaging in intestinal graft-versus-host disease: mapping of disease activity, prediction, and monitoring of treatment efficiency by positron emission tomography

Stelljes

Hermann

Albring

et al. 2008

Blood

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Gastrointestinal graft-versus-host disease (GVHD) is a common and potentially life-threatening complication after allogeneic hematopoietic stem-cell transplantation (HSCT). Noninvasive tests for assessment of GVHD activity are desirable but lacking. In the present study, we were able to visualize intestinal GVHDassociated inflammation in an allogeneic murine transplantation model by 18 IntroductionImproving results of allogeneic hematopoietic stem-cell transplantation (HSCT) have led to growing acceptance of this treatment as a potentially curative therapy for various malignant and nonmalignant diseases. [1][2][3][4][5][6][7] While the donor graft is enriched for hematopoietic progenitor and stem cells, it also contains T lymphocytes, which assist hematopoietic engraftment, restore T cell-dependent immunity, and are crucial to immunologic tumor control, usually referred to as graft-versus-tumor effect. 3,8 Besides these beneficial attributes, donor T cells are also responsible for graft-versus-host disease (GVHD), a leading cause of morbidity and lethality in patients who have undergone HSCT. 9,10 Depending on the source of the hematopoietic stem cell graft, the conditioning regimen, and the immunosuppressive treatment, the frequencies of acute GVHD vary from 20% to 50% in patients with an HLA-identical sibling donor, 11-13 and may reach 60% to 80% in patients with an HLAcompatible unrelated donor. 14 One remarkable feature of GVHD is its predilection for certain organ systems. Among them in descending frequency are the epithelial surfaces of the skin and mucous membranes, the crypts of the gastrointestinal tract, and the biliary ducts of the liver. About 80% of patients with acute GVHD have skin involvement, and more than 50% have gastrointestinal GVHD. 9,15 Intestinal GVHD is a progressive process that can affect all sections of the alimentary tract, albeit the terminal ileum and the colon are predominant sites. Symptoms are nonspecific and may include anorexia, nausea, vomiting, watery diarrhea, intestinal bleeding, abdominal pain, and ileus 16 that may also develop secondary to numerous other causes, such as infections, conditioning, and drug toxicity. [17][18][19][20] Although clinical investigation, laboratory tests, and histology usually lead to an early diagnosis of skin or liver GVHD, gastrointestinal GVHD is less readily diagnosed. 21 This is of particular concern, as GVHD remains one of the most detrimental complications after allogeneic transplantation, and the presence of gut involvement has been related to increased lethality and poor response to treatment. [22][23][24] Therefore, early recognition of intestinal GVHD is important, as prompt therapeutic intervention may prevent progression to higher-grade disease and improve outcome. [24][25][26][27][28][29] The current reference standard for diagnosis and staging of intestinal GVHD combines assessment of clinical symptoms with histologic analyses of mucosal biopsy specimens obtained by endoscopy of the upper and lower intestinal tract. 9 This appr...

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US and MRI of gastrointestinal graft-versus-host disease

Cited by 21 publications

References 0 publications

Transmural penetration of intravenously applied microbubbles during contrast-enhanced ultrasound as a new diagnostic feature in patients with GVHD of the bowel

Transmural penetration of intravenously applied microbubbles during contrast-enhanced ultrasound as a new diagnostic feature in patients with GVHD of the bowel

A PET Imaging Strategy to Visualize Activated T Cells in Acute Graft-versus-Host Disease Elicited by Allogenic Hematopoietic Cell Transplant

Clinical molecular imaging in intestinal graft-versus-host disease: mapping of disease activity, prediction, and monitoring of treatment efficiency by positron emission tomography

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