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Making computed tomography safer for patients with Crohn's disease.

John O'Grady1,2, Brian W Carey3, Richard G Kavanagh3

  • 1APC Microbiome Ireland, University College Cork, National University of Ireland, Cork, Ireland.

Scandinavian Journal of Gastroenterology
|October 26, 2021
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Low-dose computed tomography (CT) significantly reduces radiation exposure by 76.5% in Crohn's disease patients. This safe and accurate imaging method effectively evaluates disease complications, making it a viable standard of care.

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Area of Science:

  • Radiology
  • Gastroenterology
  • Medical Imaging

Background:

  • Computed tomography (CT) is widely used for Crohn's disease but involves radiation exposure.
  • Modern CT technology allows for significant radiation dose reduction without compromising accuracy.
  • Magnetic resonance imaging (MRI) is an alternative but less accessible than CT.

Purpose of the Study:

  • To compare the clinical confidence and accuracy of low-dose CT versus conventional-dose CT in patients with known Crohn's disease.
  • To assess the effectiveness of low-dose CT in the semi-acute setting for evaluating Crohn's disease complications.
  • To determine the radiation dose reduction achieved with low-dose CT.

Main Methods:

  • A comparative study involving 50 consecutive outpatients with Crohn's disease.
  • Evaluation of low-dose CT with full iterative reconstruction (IR) against conventional-dose CT.
  • Clinicians reviewed low-dose images and reports, with conventional-dose images reviewed after a 4-week interval.

Main Results:

  • Low-dose IR imaging adequately addressed the clinical question in all cases.
  • Crohn's disease complications were detected in 74% of patients with no disagreement between low- and conventional-dose imaging.
  • An effective radiation dose reduction of 76.5% was achieved (2.15 mSv vs. 6.99 mSv).

Conclusions:

  • Low-dose IR CT is a safe and accurate method for evaluating Crohn's disease distribution and complications in outpatients.
  • Low-dose radiation imaging should be considered the standard of care for Crohn's disease evaluation.
  • Low-dose CT is an acceptable alternative to MRI, especially in acute settings.