Diffusion-weighted imaging to predict longer-term response in Crohn's disease patients commencing biological therapy: Results from the MOTILITY trial

Authors: Hameed, M., Franklin, J. et al.

Journal: British Journal of Radiology

Volume: 98

Issue: 1168

Pages: 527-534

eISSN: 1748-880X

ISSN: 0007-1285

DOI: 10.1093/bjr/tqaf013

Abstract:

Objectives: Predicting longer-term response to biological therapy for small bowel Crohn's disease (SBCD) is an unmet clinical need. Diffusion-weighted magnetic resonance (MR) imaging (DWI) may indicate disease activity, but its predictive ability, if any, is unknown. We investigated the prognostic value of DWI for 1 year response or remission (RoR) in SBCD patients commencing biologic therapy, including incremental value over C-reactive protein (CRP) and faecal calprotectin (FC). Methods: A subset of participants in a prospective, multicentre study investigating the predictive ability of motility MRI for 1-year RoR in patients starting biologic therapy for active SBCD, underwent additional DWI at baseline and post-induction (12-30 weeks). CRP and FC were collected in a subgroup. RoR at 1 year was evaluated using clinical and morphological MR enterography (MRE) parameters. We calculated sensitivity and specificity to predict RoR and quality of life (QoL) at 1 year, comparing apparent diffusion coefficient (ADC) value, Clermont score, and CRP using multivariable logistic regression. Results: A total of 25 participants were included (mean 36.9 years, 32% female). ADC changes and Clermont score had poor sensitivity (30.0% [95% CI, 6.7-65.2] and 40.0% [95% CI, 12.2-73.8], respectively) and poor-to-modest specificity (50.0 [95% CI, 27.2-72.8] and 65.0% [95% CI, 40.8-84.6]) for RoR. None of Clermont score, CRP, or FC predicted QoL. Conclusions: DWI has inadequate sensitivity and specificity for RoR at 1 year. There is no significant incremental prognostic value of DWI over CRP and FC to predict RoR and/or QoL at 1 year. Advances in knowledge: Early post-induction DWI has no prognostic value for RoR at 1 year.

https://eprints.bournemouth.ac.uk/40753/

Source: Scopus

Diffusion-weighted imaging to predict longer-term response in Crohn's disease patients commencing biological therapy: results from the MOTILITY trial.

Authors: Hameed, M., Franklin, J. et al.

Journal: Br J Radiol

Volume: 98

Issue: 1168

Pages: 527-534

eISSN: 1748-880X

DOI: 10.1093/bjr/tqaf013

Abstract:

OBJECTIVES: Predicting longer-term response to biological therapy for small bowel Crohn's disease (SBCD) is an unmet clinical need. Diffusion-weighted magnetic resonance (MR) imaging (DWI) may indicate disease activity, but its predictive ability, if any, is unknown. We investigated the prognostic value of DWI for 1 year response or remission (RoR) in SBCD patients commencing biologic therapy, including incremental value over C-reactive protein (CRP) and faecal calprotectin (FC). METHODS: A subset of participants in a prospective, multicentre study investigating the predictive ability of motility MRI for 1-year RoR in patients starting biologic therapy for active SBCD, underwent additional DWI at baseline and post-induction (12-30 weeks). CRP and FC were collected in a subgroup. RoR at 1 year was evaluated using clinical and morphological MR enterography (MRE) parameters. We calculated sensitivity and specificity to predict RoR and quality of life (QoL) at 1 year, comparing apparent diffusion coefficient (ADC) value, Clermont score, and CRP using multivariable logistic regression. RESULTS: A total of 25 participants were included (mean 36.9 years, 32% female). ADC changes and Clermont score had poor sensitivity (30.0% [95% CI, 6.7-65.2] and 40.0% [95% CI, 12.2-73.8], respectively) and poor-to-modest specificity (50.0 [95% CI, 27.2-72.8] and 65.0% [95% CI, 40.8-84.6]) for RoR. None of Clermont score, CRP, or FC predicted QoL. CONCLUSIONS: DWI has inadequate sensitivity and specificity for RoR at 1 year. There is no significant incremental prognostic value of DWI over CRP and FC to predict RoR and/or QoL at 1 year. ADVANCES IN KNOWLEDGE: Early post-induction DWI has no prognostic value for RoR at 1 year.

https://eprints.bournemouth.ac.uk/40753/

Source: PubMed

Diffusion-weighted imaging to predict longer-term response in Crohn's disease patients commencing biological therapy: results from the MOTILITY trial

Authors: Hameed, M., Franklin, J. et al.

Journal: BRITISH JOURNAL OF RADIOLOGY

Volume: 98

Issue: 1168

Pages: 527-534

eISSN: 1748-880X

ISSN: 0007-1285

DOI: 10.1093/bjr/tqaf013

https://eprints.bournemouth.ac.uk/40753/

Source: Web of Science (Lite)

Diffusion-weighted imaging to predict longer-term response in Crohn's disease patients commencing biological therapy: results from the MOTILITY trial.

Authors: Hameed, M., Franklin, J. et al.

Journal: The British journal of radiology

Volume: 98

Issue: 1168

Pages: 527-534

eISSN: 1748-880X

ISSN: 0007-1285

DOI: 10.1093/bjr/tqaf013

Abstract:

Objectives

Predicting longer-term response to biological therapy for small bowel Crohn's disease (SBCD) is an unmet clinical need. Diffusion-weighted magnetic resonance (MR) imaging (DWI) may indicate disease activity, but its predictive ability, if any, is unknown. We investigated the prognostic value of DWI for 1 year response or remission (RoR) in SBCD patients commencing biologic therapy, including incremental value over C-reactive protein (CRP) and faecal calprotectin (FC).

Methods

A subset of participants in a prospective, multicentre study investigating the predictive ability of motility MRI for 1-year RoR in patients starting biologic therapy for active SBCD, underwent additional DWI at baseline and post-induction (12-30 weeks). CRP and FC were collected in a subgroup. RoR at 1 year was evaluated using clinical and morphological MR enterography (MRE) parameters. We calculated sensitivity and specificity to predict RoR and quality of life (QoL) at 1 year, comparing apparent diffusion coefficient (ADC) value, Clermont score, and CRP using multivariable logistic regression.

Results

A total of 25 participants were included (mean 36.9 years, 32% female). ADC changes and Clermont score had poor sensitivity (30.0% [95% CI, 6.7-65.2] and 40.0% [95% CI, 12.2-73.8], respectively) and poor-to-modest specificity (50.0 [95% CI, 27.2-72.8] and 65.0% [95% CI, 40.8-84.6]) for RoR. None of Clermont score, CRP, or FC predicted QoL.

Conclusions

DWI has inadequate sensitivity and specificity for RoR at 1 year. There is no significant incremental prognostic value of DWI over CRP and FC to predict RoR and/or QoL at 1 year.

Advances in knowledge

Early post-induction DWI has no prognostic value for RoR at 1 year.

https://eprints.bournemouth.ac.uk/40753/

Source: Europe PubMed Central

Diffusion weighted imaging to predict longer term response in Crohn's disease patients commencing biological therapy: Results from the MOTILITY Trial.

Authors: Hameed, M., Franklin, J. et al.

Journal: British Journal of Radiology

Volume: 98

Issue: 1168

Pages: 527-534

ISSN: 1748-880X

Abstract:

OBJECTIVES: Predicting longer term response to biological therapy for small bowel Crohn's disease (SBCD) is an unmet clinical need. Diffusion-weighted MR imaging (DWI) may indicate disease activity, but its predictive ability, if any, is unknown. We investigated the prognostic value of DWI for one year response or remission (RoR) in SBCD patients commencing biologic therapy, including incremental value over C-reactive protein (CRP) and faecal calprotectin (FC). METHODS: A subset of participants in a prospective, multicentre study investigating the predictive ability of motility MRI for one-year RoR in patients starting biologic therapy for active SBCD, underwent additional DWI at baseline and post-induction (12-30 weeks). CRP and FC were collected in a subgroup. RoR at one year was evaluated using clinical and morphological MRE parameters. We calculated sensitivity and specificity to predict RoR and Quality of life (QoL) at one year, comparing apparent diffusion coefficient (ADC) value, Clermont score and CRP using multivariable logistic regression. RESULTS: 25 participants were included (mean 36.9 years, 32% female). ADC changes and Clermont score had poor sensitivity (30.0% [95%CI: 6.7-65.2] and 40.0% [95%CI: 12.2-73.8] respectively) and poor-to-modest specificity (50.0 [95%CI: 27.2-72.8] and 65.0% [95%CI: 40.8-84.6]) for RoR. None of Clermont score, CRP or FC predicted QoL. CONCLUSIONS: DWI has inadequate sensitivity and specificity for RoR at one year. There is no significant incremental prognostic value of DWI over CRP and FC to predict RoR and/or QoL at one year. ADVANCES IN KNOWLEDGE: Early post-induction DWI has no prognostic value for RoR at one year.

https://eprints.bournemouth.ac.uk/40753/

Source: BURO EPrints