Diffusion-weighted magnetic resonance enterography for prediction of response to tumor necrosis factor inhibitors in stricturing crohn’s disease

Marianne M. Amitai, Eyal Klang, Asaf Levartovsky, Noa Rozendorn, Shelly Soffer*, Gadeer Ali Taha, Bella Ungar, Tomer Greener, Shomron Ben-Horin, Rami Eliakim, Uri Kopylov

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

15 Scopus citations

Abstract

Background and aims: Distinguishing between fibrotic and inflammatory strictures in Crohn’s disease (CD) is still challenging. The capacity of diffusion-weighted (DWI) magnetic resonance (MRE) to identify intestinal fibrosis was recently demonstrated; however, the therapeutic implications of this association have never been evaluated. The aim of the current study was to identify imaging features, including DWI, which can predict response to anti-inflammatory treatment in patients with stricturing CD. Methods: Consecutive CD patients with intestinal strictures that initiated treatment with anti-tumor necrosis alpha (anti-TNF) between June 2012 and April 2017 with MRE adjacent to treatment onset were retrospectively collected. The primary outcome was treatment failure, defined as drug discontinuation, CD-related surgery, or endoscopic dilatation of the stricture. Clinical, demographic, and imaging data were compared between patients who did and did not develop treatment failure within 12 months of anti-TNF treatment initiation. Results: A total of 21 patients were included in the study; 9/21 (42.8%) developed treatment failure. None of the clinical/demographic parameters were associated with the risk of treatment failure. Among imaging parameters, only ADC value (< 1 9 10-3 mm2/s) was significantly associated with the risk of treatment failure (AUC = 0.81, 66% vs. 0%, p = 0.015).

Original languageEnglish
Pages (from-to)3207-3212
Number of pages6
JournalAbdominal Radiology
Volume43
Issue number12
DOIs
StatePublished - 19 May 2018

Keywords

  • Crohn’s disease
  • Diffusion magnetic resonance imaging
  • Fibrosis
  • Magnetic resonance imaging
  • Tumor necrosis factor

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