Quantified motility in Crohn's disease to evaluate stricture composition using cine-MRI

Area of Science:

• Gastroenterology
• Radiology
• Pathology

Background:

• Histopathological composition of strictures is crucial for selecting appropriate clinical treatment in Crohn's disease (CD).
• Identifying imaging biomarkers to distinguish inflammatory from chronic strictures is highly relevant for patient management.

Purpose of the Study:

• To determine if quantified motility on cine-magnetic resonance imaging (cine-MRI) can differentiate inflammatory (inflammatory and mixed) from chronic (non-inflammatory) strictures in CD patients.
• To explore the potential of cine-MRI motility as an imaging biomarker for stricture characterization.

Main Methods:

• A prospective cross-sectional study involving CD patients scheduled for small bowel resection.
• 2D cine-MRI was performed, and small bowel stricture and pre-stricture dilatation motility were quantified using GIQuant.
• Resection specimens were histopathologically scored as predominantly inflammatory, mixed, or predominantly chronic (non-inflammatory).

Main Results:

• Twenty-eight CD patients with 30 strictures were analyzed.
• Pre-stricture dilatation motility was significantly higher in chronic (non-inflammatory) strictures compared to inflammatory strictures (P=.004).
• Cine-MRI demonstrated a high area under the curve (AUC=0.93) for detecting chronic strictures; however, motility within strictures did not differ by histopathology (P=.6).

Conclusions:

• Motility in pre-stricture dilatations is higher in chronic (non-inflammatory) strictures than in inflammatory strictures.
• Quantified motility of pre-stricture dilatations using cine-MRI shows potential as an imaging biomarker to distinguish between chronic and inflammatory strictures in CD.
• This distinction can inform treatment choices for CD-related strictures.