TY - JOUR
T1 - Diffusion-weighted magnetic resonance enterography for prediction of response to tumor necrosis factor inhibitors in stricturing crohn’s disease
AU - Amitai, Marianne M.
AU - Klang, Eyal
AU - Levartovsky, Asaf
AU - Rozendorn, Noa
AU - Soffer, Shelly
AU - Taha, Gadeer Ali
AU - Ungar, Bella
AU - Greener, Tomer
AU - Ben-Horin, Shomron
AU - Eliakim, Rami
AU - Kopylov, Uri
N1 - Publisher Copyright:
© Springer Science+Business Media, LLC, part of Springer Nature 2018.
PY - 2018/5/19
Y1 - 2018/5/19
N2 - 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).
AB - 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).
KW - Crohn’s disease
KW - Diffusion magnetic resonance imaging
KW - Fibrosis
KW - Magnetic resonance imaging
KW - Tumor necrosis factor
UR - http://www.scopus.com/inward/record.url?scp=85047135502&partnerID=8YFLogxK
U2 - 10.1007/s00261-018-1626-9
DO - 10.1007/s00261-018-1626-9
M3 - ???researchoutput.researchoutputtypes.contributiontojournal.article???
C2 - 29779158
AN - SCOPUS:85047135502
SN - 2366-004X
VL - 43
SP - 3207
EP - 3212
JO - Abdominal Radiology
JF - Abdominal Radiology
IS - 12
ER -