A Systematic Review of Technical Parameters for MR of the Small Bowel in non-IBD Conditions over the Last Ten Years

Abstract Technical guidelines for magnetic resonance imaging (MRI) of the small bowel (SB) in the setting of inflammatory bowel diseases (IBDs) were detailed in a 2017 consensus issued by European Society of Gastrointestinal and Abdominal Radiology (ESGAR) and European Society of Pediatric Radiology (ESPR); however, MRI for non-IBD conditions was not addressed. Hence, we performed a systematic review collecting researches on SB MRI for non-IBDs. The literatures were then divided into morphologic group and functional group. Information about the MRI techniques, gastrointestinal preparation, and details of cine-MRI protocols was extracted. We found that a 1.5 T MRI system, prone positioning, and MR enterography were frequently utilized in clinical practice. Gadolinium contrast sequences were routinely implemented, while diffusion-weighted imaging (DWI) was much less performed. The gastrointestinal preparation varied throughout the studies. No uniform protocols for cine imaging could be established. SB MRI examinations for non-IBDs are far from standardized, especially for functional studies. Recommendations for standard parameters in cine-MRI sequences are difficult to make due to lack of evidentiary support. MRI investigations in non-IBD conditions are needed and the standardization of non-IBD imaging in clinical practice is required.

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Implementation of European Society of Gastrointestinal Endoscopy (ESGE) recommendations for small-bowel capsule endoscopy into clinical practice: Results of an official ESGE survey

Endoscopy ◽

10.1055/a-1541-2938 ◽

2021 ◽

Author(s):

Lazaros-Dimitrios Lazaridis ◽

Georgios Tziatzios ◽

Ervin Toth ◽

Hanneke Beaumont ◽

Xavier Dray ◽

...

Keyword(s):

Crohn’S Disease ◽

Clinical Practice ◽

Small Bowel ◽

Crohn's Disease ◽

Capsule Endoscopy ◽

Bowel Preparation ◽

European Society ◽

Gastrointestinal Endoscopy ◽

Deficiency Anemia ◽

National Society

Abstract Background We aimed to document international practices in small-bowel capsule endoscopy (SBCE), measuring adherence to European Society of Gastrointestinal Endoscopy (ESGE) technical and clinical recommendations. Methods Participants reached through the ESGE contact list completed a 52-item web-based survey. Results 217 responded from 47 countries (176 and 41, respectively, from countries with or without a national society affiliated to ESGE). Of respondents, 45 % had undergone formal SBCE training. Among SBCE procedures, 91 % were performed with an ESGE recommended indication, obscure gastrointestinal bleeding (OGIB), iron-deficiency anemia (IDA), and suspected/established Crohn’s disease being the commonest and with higher rates of positive findings (49.4 %, 38.2 % and 53.5 %, respectively). A watchful waiting strategy after a negative SBCE for OGIB or IDA was preferred by 46.7 % and 70.3 %, respectively. SBCE was a second-line exam for evaluation of extent of new Crohn’s disease for 62.2 % of respondents. Endoscopists adhered to varying extents to ESGE technical recommendations regarding bowel preparation ( > 60 %), use in those with pacemaker holders (62.5 %), patency capsule use (51.2 %), and use of a validated scale for bowel preparation assessment (13.3 %). Of the respondents, 67 % read and interpreted the exams themselves and 84 % classified exams findings as relevant or irrelevant. Two thirds anticipated future increase in SBCE demand. Inability to obtain tissue (78.3 %) and high cost (68.1 %) were regarded as the main limitations, and implementation of artificial intelligence as the top development priority (56.2 %). Conclusions To some extent, endoscopists follow ESGE guidelines on using SBCE in clinical practice. However, variations in practice have been identified, whose implications require further evaluation.

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Inter-radiologist agreement using Society of Abdominal Radiology-American Gastroenterological Association (SAR-AGA) consensus nomenclature for reporting CT and MR enterography in children and young adults with small bowel Crohn disease

Abdominal Radiology ◽

10.1007/s00261-018-1743-5 ◽

2018 ◽

Vol 44 (2) ◽

pp. 391-397 ◽

Cited By ~ 2

Author(s):

Mitchell A. Rees ◽

Jonathan R. Dillman ◽

Christopher G. Anton ◽

Mantosh S. Rattan ◽

Ethan A. Smith ◽

...

Keyword(s):

Young Adults ◽

Small Bowel ◽

Crohn Disease ◽

Mr Enterography ◽

American Gastroenterological Association ◽

Abdominal Radiology ◽

Children And Young Adults

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The role of MR enterography in the diagnosis of IBD and other small bowel diseases from a gastroenterologist perspective

Zeitschrift für Gastroenterologie ◽

10.1055/s-0033-1347531 ◽

2013 ◽

Vol 51 (05) ◽

Author(s):

M Varga ◽

K Csefkó ◽

E Balla ◽

T Pink ◽

A Gaál ◽

...

Keyword(s):

Small Bowel ◽

Mr Enterography ◽

Bowel Diseases ◽

Small Bowel Diseases

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WikiRecs primary care: developing rapid recommendations for primary care through effective collaboration between systematic review and guideline teams

British Journal of General Practice ◽

10.3399/bjgp18x697085 ◽

2018 ◽

Vol 68 (suppl 1) ◽

pp. bjgp18X697085

Author(s):

Trudy Bekkering ◽

Bert Aertgeerts ◽

Ton Kuijpers ◽

Mieke Vermandere ◽

Jako Burgers ◽

...

Keyword(s):

Systematic Review ◽

Primary Care ◽

Clinical Practice ◽

Primary Care Physicians ◽

Urinary Stones ◽

Care Practice ◽

Supporting Evidence ◽

Supervised Exercise ◽

Review Team ◽

New Evidence

BackgroundThe WikiRecs evidence summaries and recommendations for clinical practice are developed using trustworthy methods. The process is triggered by studies that may potentially change practice, aiming at implementing new evidence into practice fast.AimTo share our first experiences developing WikiRecs for primary care and to reflect on the possibilities and pitfalls of this method.MethodIn March 2017, we started developing WikiRecs for primary health care to speed up the process of making potentially practice-changing evidence in clinical practice. Based on a well-structured question a systematic review team summarises the evidence using the GRADE approach. Subsequently, an international panel of primary care physicians, methodological experts and patients formulates recommendations for clinical practice. The patient representatives are involved as full guideline panel members. The final recommendations and supporting evidence are disseminated using various platforms, including MAGICapp and scientific journals.ResultsWe are developing WikiRecs on two topics: alpha-blockers for urinary stones and supervised exercise therapy for intermittent claudication. We did not face major problems but will reflect on issues we had to solve so far. We anticipate having the first WikiRecs for primary care available at the end of 2017.ConclusionThe WikiRecs process is a promising method — that is still evolving — to rapidly synthesise and bring new evidence into primary care practice, while adhering to high quality standards.

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