The Effectiveness of CT Enterography in the Radiological Evaluation of Crohn’s Disease

Abstract Background Evaluating structural damage using imaging is essential for the evaluation of small intestinal Crohn’s disease (CD), but it is limited by potential interobserver variation. We compared the agreement of enterography-based bowel damage measurements collected by experienced radiologists and a semi-automated image analysis system. Methods Patients with small bowel CD undergoing a CT-enterography (CTE) between 2011 and 2017 in a tertiary care setting were retrospectively reviewed. CT-enterography studies were reviewed by 2 experienced radiologists and separately underwent automated computer image analysis using bowel measurement software. Measurements included maximum bowel wall thickness (BWT-max), maximum bowel dilation (DIL-max), minimum lumen diameter (LUM-min), and the presence of a stricture. Measurement correlation coefficients and paired t tests were used to compare individual operator measurements. Multivariate regression was used to model identification of strictures using semi-automated measures. Results In 138 studies, the correlation between radiologists and semi-automated measures were similar for BWT-max (r = 0.724, 0.702), DIL-max (r = 0.812, 0.748), and LUM-min (r = 0.428, 0.381), respectively. Mean absolute measurement difference between semi-automated and radiologist measures were no different from the mean difference between paired radiologists for BWT-max (1.26 mm vs 1.12 mm, P = 0.857), DIL-max (2.78 mm vs 2.67 mm, P = 0.557), and LUM-min (0.54 mm vs 0.41 mm, P = 0.596). Finally, models of radiologist-defined intestinal strictures using automatically acquired measurements had an accuracy of 87.6%. Conclusion Structural bowel damage measurements collected by semi-automated approaches are comparable to those of experienced radiologists. Radiomic measures of CD will become an important new data source powering clinical decision-making, patient-phenotyping, and assisting radiologists in reporting objective measures of disease status.

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Ileal Crohn's disease activity predicted by ruler: CT enterography histopathology correlation

The Egyptian Journal of Radiology and Nuclear Medicine ◽

10.1016/j.ejrnm.2017.01.001 ◽

2017 ◽

Vol 48 (1) ◽

pp. 7-13

Author(s):

Tamer W. Kassem

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Disease Activity ◽

Ct Enterography ◽

Crohn’S Disease Activity

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Low Sensitivities of MR- and CT-Enterography for Detection of Small Bowel Stenosis in Patients With Known Crohn's Disease

Gastroenterology ◽

10.1016/s0016-5085(11)63155-7 ◽

2011 ◽

Vol 140 (5) ◽

pp. S-759-S-760 ◽

Cited By ~ 1

Author(s):

Michael D. Jensen ◽

Jens Kjeldsen ◽

Søren R. Rafaelsen ◽

Torben Nathan

Keyword(s):

Crohn’S Disease ◽

Small Bowel ◽

Crohn's Disease ◽

Ct Enterography

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Multiparametric Evaluation Predicts Different Mid-Term Outcomes in Crohn’s Disease

Digestive Diseases ◽

10.1159/000487589 ◽

2018 ◽

Vol 36 (3) ◽

pp. 184-193 ◽

Cited By ~ 5

Author(s):

Lucrezia Laterza ◽

Anna Chiara Piscaglia ◽

Laura Maria Minordi ◽

Iolanda Scoleri ◽

Luigi Larosa ◽

...

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Disease Activity ◽

Mucosal Healing ◽

Hospitalization Rate ◽

Clinical Activity ◽

Ct Enterography ◽

Complementary Information ◽

Endoscopic Remission ◽

Rutgeerts Score

Aim: To evaluate if a single and/or combined (clinical, endoscopic and radiological) assessment could predict clinical outcomes in Crohn’s disease (CD). Methods: We prospectively evaluated 57 CD cases who underwent both a colonoscopy and a CT-enterography (CTE). Harvey-Bradshaw Index (HBi), SES-CD (and/or Rutgeerts score) and the radiological disease activity were defined to stratify patients according to clinical, endoscopic and radiological disease activity respectively. Hospitalizations, surgery, therapeutic changes and deaths were evaluated up to 36 months (time 1) for 53 patients. Results: CTE and endoscopy agreed in stratifying disease activity in 47% of cases (k = –0.05; p = 0.694), CTE and HBi in 35% (k = 0.09; p = 0.08), endoscopy and HBi in 39% (k = 0.13; p = 0.03). Taken together, CTE, endoscopy and HBi agreed only in 18% of cases (k = 0.01; p = 0.41). Among the 11 cases with mucosal healing, only 3 (27%) showed transmural healing. Patients with endoscopic activity needed significantly more changes of therapy compared to patients with endoscopic remission (p = 0.02). Patients with higher transmural or clinical activity at baseline required significantly more hospitalizations (p < 0.01). Hospitalization rate decreases with an increase in the number of parameters indicating remissions at baseline (p = 0.04). Conclusions: Clinical, endoscopic and radiological assessments offer complementary information and could predict different mid-term outcomes in CD.

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