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Quantitative Magnetic Resonance Imaging in Perianal Crohn's Disease at 1.5 and 3.0 T: A Feasibility Study
Ali Alyami1,2,3, Caroline L Hoad3,4, Christopher Tench3,5
1Department of Diagnostic Radiography Technology, College of Applied Medical Sciences, Jazan University, Jazan 45142, Saudi Arabia.
Abstract:
Perianal Crohn's Disease (pCD) is a common manifestation of Crohn's Disease. Absence of reliable disease measures makes disease monitoring unreliable. Qualitative MRI has been increasingly used for diagnosing and monitoring pCD and has shown potential for assessing response to treatment. Quantitative MRI sequences, such as diffusion-weighted imaging (DWI), dynamic contrast enhancement (DCE) and magnetisation transfer (MT), along with T2 relaxometry, offer opportunities to improve diagnostic capability. Quantitative MRI sequences (DWI, DCE, MT and T2) were used in a cohort of 25 pCD patients before and 12 weeks after biological therapy at two different field strengths (1.5 and 3 T). Disease activity was measured with the Perianal Crohn's Disease Activity index (PDAI) and serum C-reactive protein (CRP). Diseased tissue areas on MRI were defined by a radiologist. A baseline model to predict outcome at 12 weeks was developed. No differences were seen in the quantitative MR measured in the diseased tissue regions from baseline to 12 weeks; however, PDAI and CRP decreased. Baseline PDAI, CRP, T2 relaxometry and surgical history were found to have a moderate ability to predict response after 12 weeks of biological treatment. Validation in larger cohorts with MRI and clinical measures are needed in order to further develop the model.
Insights
Quantitative MRI shows potential for monitoring perianal Crohn's Disease (pCD) treatment response. While MRI measures didn't change, clinical markers improved, suggesting MRI may help predict treatment outcomes.
Area of Science:
- Gastroenterology
- Radiology
- Medical Imaging
Background:
- Perianal Crohn's Disease (pCD) monitoring is challenging due to unreliable disease measures.
- Qualitative MRI is used for pCD diagnosis and monitoring, with potential for treatment response assessment.
- Quantitative MRI sequences (DWI, DCE, MT, T2) offer enhanced diagnostic capabilities.
Purpose of the Study:
- To evaluate the utility of quantitative MRI sequences in assessing treatment response in pCD patients.
- To develop a baseline model for predicting treatment outcomes in pCD after 12 weeks of biological therapy.
Main Methods:
- A cohort of 25 pCD patients underwent quantitative MRI (DWI, DCE, MT, T2) at 1.5 T and 3 T before and after 12 weeks of biological therapy.
- Disease activity was assessed using the Perianal Crohn's Disease Activity Index (PDAI) and serum C-reactive protein (CRP).
- Radiologists identified diseased tissue areas on MRI for quantitative analysis.
Main Results:
- No significant changes were observed in quantitative MRI measures within diseased tissue regions from baseline to 12 weeks.
- A decrease in PDAI and CRP levels was noted, indicating clinical improvement.
- Baseline PDAI, CRP, T2 relaxometry, and surgical history moderately predicted treatment response at 12 weeks.
Conclusions:
- Quantitative MRI measures did not significantly change despite clinical improvement in pCD patients undergoing biological therapy.
- A predictive model incorporating baseline clinical and MRI parameters shows moderate ability to forecast treatment response.
- Further validation in larger cohorts is necessary to refine the predictive model for pCD management.
