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pTRACK-generated normalized average T2 signal intensity and fistula volume are accurate and sensitive measures of
I Naim1,2, C Greer3, G Bhatnagar1
1Motilent Ltd, London, E1 8FA, United Kingdom.
Objectives:
Fistula T2 signal intensity and volume are predictive of treatment response in IBD. We aimed to evaluate pTRACK-generated MRI metrics against MAGNIFI-CD, assessing predictive value for clinical outcomes.
Methods:
MRI and clinical assessment cases of 46 patients with pCD were included. T2 signal intensity was normalized using ROI in adjacent pelvic muscles. Clinical outcomes were scored using physician global assessment. Correlations, unpaired 2-tailed t-tests, and receiver operating characteristics curve analyses performance metrics were used to compare MRI metrics and predict PGA categories.
Results:
Normalized average T2 signal intensity demonstrated AUC 0.784 (95% CI: 0.648-0.893). Optimal threshold for classification was 1.527, with accuracy of 80.0%, with high sensitivity (0.857) and moderate specificity (0.632). MAGNIFI-CD scores (ICC = 0.87, 95% CI: 0.45-0.98, P = .0014), fistula volume (ICC = 0.81, 95% CI: 0.21-0.97, P = .0103) showed good-excellent reliability. Significant differences were observed when dichotomized into remission and active groups: T2 signal intensity (1.55 ms ± 0.88 vs. 2.87 ms ± 1.42, P < .001), fistula volume (2.0 ± 3.3 mL vs. 4.3 ± 8.7 mL, P = .04) and MAGNIFI-CD (5.86 ± 4.70 vs. 12.41 ± 5.80, P < .001).
Conclusions:
pTRACK's normalized T2 signal demonstrated comparable accuracy to MAGNIFI-CD, with higher sensitivity for predicting pCD activity. These findings underscore pTRACK's potential utility, warranting prospective validation in cohorts with more severe disease.
Advances In Knowledge:
pTRACK enables radiologists to measure fistula volume, normalized average T2 signal intensity, and generate 3D digital models, and has shown comparable accuracy to MAGNIFI-CD.
Insights
pTRACK’s normalized T2 signal intensity shows high accuracy in predicting perianal Crohn's disease activity, comparable to MAGNIFI-CD. This MRI metric offers a sensitive tool for assessing treatment response in IBD patients.
Area of Science:
- Radiology and Gastroenterology
- Medical Imaging Analysis
- Inflammatory Bowel Disease (IBD) Research
Background:
- Fistula T2 signal intensity and volume are established predictors of treatment response in IBD.
- Evaluating novel MRI metrics against existing standards is crucial for clinical utility.
Purpose of the Study:
- To assess the predictive value of pTRACK-generated MRI metrics for clinical outcomes in perianal Crohn's disease (pCD).
- To compare pTRACK MRI metrics against the MAGNIFI-CD scoring system.
Main Methods:
- MRI and clinical assessments of 46 pCD patients were analyzed.
- Normalized T2 signal intensity was measured using ROIs in adjacent pelvic muscles.
- Physician global assessment (PGA) was used for clinical outcomes; statistical analyses included correlations, t-tests, and ROC curves.
Main Results:
- Normalized average T2 signal intensity achieved an AUC of 0.784, with 80.0% accuracy at a threshold of 1.527.
- Significant differences in T2 signal intensity, fistula volume, and MAGNIFI-CD scores were observed between remission and active disease groups.
- pTRACK metrics demonstrated good-to-excellent reliability, comparable to MAGNIFI-CD.
Conclusions:
- pTRACK's normalized T2 signal intensity offers accuracy comparable to MAGNIFI-CD for predicting pCD activity, with higher sensitivity.
- These findings highlight pTRACK's potential as a valuable tool in managing IBD.
- Further prospective validation in severe disease cohorts is warranted.
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