British Journal of Radiology最新文献

{"title":"Electrochemotherapy in metastatic epidural spinal cord compression: a review and technical update.","authors":"F Deschamps, L Tselikas, R L Cazzato, G Facchini, V Granata, B Bonnet, V D'Alessio, R Fusco, A Zanasi, F De Terlizzi, A Gangi, T de Baere, L M Mir","doi":"10.1093/bjr/tqae219","DOIUrl":"https://doi.org/10.1093/bjr/tqae219","url":null,"abstract":"<p><p>This review aims to analyse the safety and clinical efficacy in terms of pain relief and local tumour control, in patients with metastatic epidural spinal cord compression undergoing electrochemotherapy (ECT). Moreover, a recommendation detailing optimal electrodes insertion is proposed with the intent of improving treatment planning. Clinical studies published between 2015 and 2023 were included since this time window is consistent with recent developments in the field of ECT of spinal metastases. In the whole, three articles were included. Results showed that percutaneous image-guided ECT provides effective pain relief with limited procedure-related morbidity, along with local tumour control (complete response 28.5%, 38% partial response, 24% stable disease) at 3- month follow-up in the largest published series so far. In conclusion, ECT should integrate the armamentarium of therapies that are currently being proposed to patients with painful metastatic epidural disease.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revolutionising Osseous Biopsy: The Impact of Artificial Intelligence in the Era of Personalised Medicine.","authors":"Amanda Isaac, Michail E Klontzas, Danoob Dalili, Asli Irmak Akdogan, Mohamed Fawzi, Giuseppe Gugliemi, Dimitrios Filippiadis","doi":"10.1093/bjr/tqaf018","DOIUrl":"https://doi.org/10.1093/bjr/tqaf018","url":null,"abstract":"<p><p>In a rapidly evolving healthcare environment, artificial intelligence (AI) is transforming diagnostic techniques and personalised medicine. This is also seen in osseous biopsies. AI applications in radiomics, histopathology, predictive modelling, biopsy navigation, and interdisciplinary communication are reshaping how bone biopsies are conducted and interpreted. We provide a brief review of AI in image- guided biopsy of bone tumours (primary and secondary) and specimen handling, in the era of personalised medicine. This paper explores AI's role in enhancing diagnostic accuracy, improving safety in biopsies, and enabling more precise targeting in bone lesion biopsies, ultimately contributing to better patient outcomes in personalised medicine. We dive into various AI technologies applied to osseous biopsies, such as traditional machine learning, deep learning, radiomics, simulation and generative models. We explore their roles in tumour board meetings, communication between clinicians, radiologists, and pathologists. Additionally, we inspect ethical considerations associated with the integration of AI in bone biopsy procedures, technical limitations, and we delve into health equity, generalisability, deployment issues, and reimbursement challenges in AI-powered healthcare. Finally, we explore potential future developments and offer a list of open-source AI tools and algorithms relevant to bone biopsies, which we include to encourage further discussion and research.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143058063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real world clinical experience of using Brainomix e-CTA software in a medium size acute NHS trust.","authors":"F Merchant, J Choulterton, R James, C L Pang","doi":"10.1093/bjr/tqaf019","DOIUrl":"https://doi.org/10.1093/bjr/tqaf019","url":null,"abstract":"<p><strong>Objectives: </strong>Artificial intelligence (AI) software including Brainomix \"e-CTA\" which detect large vessel occlusions (LVO) have clinical potential. We hypothesised that in real world use where prevalence is low, its clinical utility may be overstated.</p><p><strong>Methods: </strong>In this single centre retrospective service evaluation project, data sent to Brainomix from a medium size acute National Health Service (NHS) Trust hospital between 1/3/2022-1/3/2023 was reviewed. 584 intracranial computed tomography angiogram (CTA) datasets were analysed for LVO by e-CTA. The e-CTA output and radiology report were compared to ground truth, defined by a consultant radiologist with fellowship neuroradiology training, with access to subsequent imaging and clinical notes. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated.</p><p><strong>Results: </strong>Of 584 cases (45% female, mean age 70 ± 16 years), 9% (n = 50) had LVO. e-CTA had a sensitivity of 0.78 (95% CI 0.64-0.88), specificity of 0.93 (0.9-0.95), PPV of 0.5 (0.42-0.58) and NPV of 0.98 (0.96-0.99). e-CTA had an error rate of 9% (52/584). Erroneous cases were categorised into causes for error. Common causes for false positives included incorrect anatomy (21%, 8/39) and other pathology (13%, 5/39), with several uncategorisable cases (39%, 15/39). Common causes for false negatives included LVO within the terminal internal carotid artery (ICA) (55%, 6/11) and uncategorisable (18%, 2/11).</p><p><strong>Conclusions: </strong>We demonstrated that PPV of e-CTA is poor in consecutive cases in a real-world NHS setting. We advocate for local validation of AI software prior to clinical use.</p><p><strong>Advances in knowledge: </strong>Common AI errors were due to anatomical misidentification, presence of other pathology, and misidentifying LVO in the terminal ICA.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143058036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Trials in Cancer Theranostics with Potential Near-Term Impact on Clinical Practice.","authors":"Hossein Jadvar, Abtin Doroudinia, Peter S Conti, Patrick M Colletti","doi":"10.1093/bjr/tqaf017","DOIUrl":"https://doi.org/10.1093/bjr/tqaf017","url":null,"abstract":"<p><p>Theranostics has its roots with the first radioiodine therapy for thyroid diseases in about 80 years ago. More recently the field has experienced a remarkable renascence with the regulatory approval of paired imaging and radiopharmaceutical therapy agents in gastroenteropancreatic neuroendocrine tumors and metastatic castration-resistant prostate cancer that are now employed in routine clinical practice. The momentum is strong for identification and testing of new theranostic agents for use in various cancers and finding new clinical incications of the available agents. There are currently numerous preclinical, first-in-human studies, large-scale prospective registries, and clinical trials including randomized trials underway in cancer theranostics that target a variety of germane biological targets. The results of these investigations, if successful, will undoubtedly impact the future of cancer management which is anticipated to improve patient outcome. Multi-targeted theranostics may also provide opportunities for synergistic efficacy to tackle the inherent complexities driven by the heterogeneity of cancer. In this article, we review the currently active recruiting phase 2 and phase 3 clinical trials in cancer theranostics that are targeted to the prostate-specific membrane antigen, gastrin-releasing peptide receptor, and fibroblast activation protein, with the anticipated potential near-term (<5 years) impact on clinical practice.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143051790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Human-in-the-loop machine learning-based quantitative assessment of hemifacial spasm based on volumetric interpolated breath-hold examination MR.","authors":"Zengan Huang, Xinyi Wang, Xiaoming Liu, Jingwen Li, Xinyu Hu, Qinwei Yu, Guiying Kuang, Nian Xiong, Yi Gao","doi":"10.1093/bjr/tqaf010","DOIUrl":"https://doi.org/10.1093/bjr/tqaf010","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of this study was to assess the severity of hemifacial spasm (HFS) through quantitative measures that associated it with neurovascular contact (NVC).</p><p><strong>Methods: </strong>We enrolled 108 HFS patients (63 severe and 45 mild cases) and implemented a human-in-the-loop approach to develop a quantitative NVC feature package. This process involved using interactive segmentation on three-dimensional volumetric interpolated breath-hold examination (VIBE) MR images to delineate vascular and nerve structures. From these segmentations, we extracted quantitative NVC features, forming an NVC feature package, and applied a support vector machine model to assess HFS severity.</p><p><strong>Results: </strong>Our interactive segmentation technique achieved high accuracy (Dice similarity coefficients of 0.905 ± 0.030 for vascular structures and 0.922 ± 0.086 for nerves). The NVC feature package, comprising distance between vascular structures and nerves, vascular diameter, their ratio, and clinical characteristics, enabled our model to assess HFS severity with an AUC of 0.823 (95% CI: 0.714-0.932, p < 0.001).</p><p><strong>Conclusion: </strong>This study introduced a quantitative approach to understanding the relationship between HFS severity and NVC, using VIBE MR imaging. Our model offers a promising tool for enhancing clinical decision-making and offers deeper insights into the impact of NVCon HFS, aiming to improve patient outcomes.</p><p><strong>Advances in knowledge: </strong>Microvascular decompression is well-established as a safe and effective treatment for HFS. However, there is a gap assessing the severity of HFS using quantitative measures that directly link it to NVC. Our method introduced a quantitative and objective alternative for assessing the severity of HFS to addressing this gap.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143063899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of adaptive statistical iterative reconstruction-V algorithm and deep learning image reconstruction algorithm on image quality and emphysema quantification in COPD patients under ultra-low-dose conditions.","authors":"Guangming Ma, Yuequn Dou, Shan Dang, Nan Yu, Yanbing Guo, Dong Han, Chenwang Jin","doi":"10.1093/bjr/tqae251","DOIUrl":"https://doi.org/10.1093/bjr/tqae251","url":null,"abstract":"<p><strong>Purpose: </strong>To explore the effect of different reconstruction algorithms (ASIR-V and DLIR) on image quality and emphysema quantification in chronic obstructive pulmonary disease (COPD) patients under ultra-low-dose scanning conditions.</p><p><strong>Materials and methods: </strong>This prospective study with patient consent included 62 COPD patients. Patients were examined by pulmonary function test (PFT), standard-dose CT (SDCT) and ultra-low-dose CT (ULDCT). SDCT images were reconstructed with filtered-back-projection (FBP), while ULDCT images were reconstructed using FBP, 30%ASIR-V, 60%ASIR-V, 90%ASIR-V, low-strength (DLIR-L), medium-strength (DLIR-M) and high-strength DLIR (DLIR-H) to form 8 image sets. Images were analyzed using a commercial computer aided diagnosis (CAD) software. Parameters such as image noise, lung volume (LV), emphysema index (EI), mean lung density (MLD), 15th percentile of lung density (PD15) were measured. Two radiologists evaluated tracheal and pulmonary artery image quality using a 5-point scale. Measurements were compared and the correlation between EI and PFT indices was analyzed.</p><p><strong>Result: </strong>ULDCT used 0.46 ± 0.22mSv in radiation dose, 93.8% lower than SDCT (P < 0.001). There was no difference in LV and MLD among image groups (P > 0.05). ULDCT-ASIR-V90% and ULDCT-DLIR-M had similar image noise and EI and PD15 values to SDCT-FBP, and ULDCT-DLIR-M and ULDCT-DLIR-H had similar subjective scores to SDCT-FBP (all P > 0.05). ULDCT-DLIR-M provided the best correlation between EI and the FEV1/FVC and FEV1% indices in PFT, and the lowest deviations with SDCT-FBP in both EI and PD15.</p><p><strong>Conclusion: </strong>DLIR-M provides the best image quality and emphysema quantification for COPD patients in ULDCT.</p><p><strong>Advances in knowledge: </strong>Ultra-low-dose CT scanning combined with DLIR-M reconstruction is comparable to standard dose images for quantitative analysis of emphysema and image quality.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143036929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A preliminary study of microwave ablation (MWA) for Bethesda IV follicular neoplasms (≤3 cm).","authors":"Xin-Yu Yu, Xin-Yi Zhou, Ying Wei, Zheng-Long Zhao, Li-Li Peng, Yan Li, Jie Wu, Shi-Liang Cao, Ming-An Yu","doi":"10.1093/bjr/tqaf015","DOIUrl":"https://doi.org/10.1093/bjr/tqaf015","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the feasibility, safety, and efficacy of microwave ablation (MWA) for the treatment of patients with Bethesda IV follicular neoplasms (FNs) (≤3 cm).</p><p><strong>Methods: </strong>In the retrospective study, patients who underwent MWA for Bethesda IV follicular neoplasms (≤3 cm) were included. Technical success, volume reduction, disease progression, and adverse event (AE) rates were analyzed postablation.</p><p><strong>Results: </strong>The study cohort consisted of 44 patients with a mean age of 48.2 ± 15.7 years. The median follow-up period was 16 months (IQR: 9-24 months). The technical success rate was 100%. The median volume reduction ratio (VRR) reached 100% (IQR: 98.8%-100.0%) after the 18th month of follow-up. The disease progression rate was 4.5% (2/44), and both of those patients experienced local recurrence. The overall AE rate was 9.1% (4/44), and AEs included three cases of voice hoarseness and one case of cough.</p><p><strong>Conclusion: </strong>This study presents promising clinical outcomes regarding the feasibility, efficacy, and safety of MWA for the treatment of patients with Bethesda IV follicular neoplasms ≤ 3 cm.</p><p><strong>Advances in knowledge: </strong>The study highlights the high technical success rate, low disease progression rate and AE rate of MWA for FNs, which underscores its potential for broader application. Future research should aim to validate these results in larger populations to increase the scope of therapy for FNs.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143036926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The value of ultrasound measured rectus femoris thickness, cross-sectional area and shear wave velocity in assessment of muscle in postmenopausal women with osteosarcopenia.","authors":"Zi-Tong Chen, Jia-Ying Ge, Feng-Shan Jin, Le-Hang Guo, Qiao Wang, Hui Zhao, Li-Ping Sun, Hui-Xiong Xu, Hui Sheng, Xiao-Long Li","doi":"10.1093/bjr/tqaf012","DOIUrl":"https://doi.org/10.1093/bjr/tqaf012","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the value of ultrasound (US) and shear wave velocity (SWV) to assess muscle in postmenopausal women with osteosarcopenia (OSP).</p><p><strong>Methods: </strong>This study included 145 postmenopausal women, comprising 115 osteopenia/osteoporosis participants without sarcopenia (OP alone) and 30 OSP participants. All received the evaluation of bone mineral density (BMD), appendicular skeletal muscle mass index (ASMI), handgrip strength, calf circumference, 6-meter walking speed, and 5-time chair stand test. The cross-sectional area (RFcsa), thickness (RFthickness), and mean SWV of rectus femoris (RF) were measured by US and shear wave elastography. The clinical characteristics, RFcsa, RFthickness, and SWV, were compared between OP alone and OSP to determine the independent predictors of OSP. Receiver operating characteristic (ROC) curve analysis was used to evaluate the value of US and SWV for assessment of OSP.</p><p><strong>Results: </strong>The RFcsa, RFthickness, SWV, and BMD of OSP were lower than those of OP alone (all P < 0.05). Through multivariate analysis, the diagnostic performance of the prediction model (area under the ROC curve, AUC, 0.917) composed of RFcsa and SWV was superior to RFcsa (AUC, 0.847), RFthickness (AUC, 0.797), and SWV (AUC, 0.740) alone. Moreover, the prediction model achieved 70.0% sensitivity, 93.0% specificity, and 88.3% accuracy.</p><p><strong>Conclusions: </strong>The RFcsa, RFthickness, and SWV have potential value in assessing muscle in OSP and can be applied to routine clinical management of postmenopausal women.</p><p><strong>Advances in knowledge: </strong>US measured RF thickness, CSA and SWV could assist detection and clinical management of OSP in postmenopausal women.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143032298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dynamic contrast enhanced MRI in nodal lymphoma: correlation of quantitative MR perfusion parameters with lymphoma subtype, Lugano stage and Ki-67 index.","authors":"Rohit Kataria, Rohini Gupta Ghasi, S P Kataria, Sachin Kolte","doi":"10.1093/bjr/tqaf016","DOIUrl":"https://doi.org/10.1093/bjr/tqaf016","url":null,"abstract":"<p><strong>Background: </strong>Research into the intratumoral microenvironment in lymphoma has been escalated along with improved survival and new targeted therapies with an intent to refine risk stratification and prognostication. Various studies have reported significance of quantitative DCE-MRI parameters for predicting biological behaviour of various tumors. This study is an endeavour to supplement the existing literature on quantitative DCE-MRI in nodal lymphoma.</p><p><strong>Objectives: </strong>To study the correlation of quantitative DCE-MRI parameters of Ktrans, Kep and Ve with subtype, Lugano stage at diagnosis and Ki-67 proliferation index (PI) in nodal lymphoma.</p><p><strong>Methods: </strong>33 patients of age > 12 years with newly diagnosed nodal lymphoma underwent DCE-MRI. Ktrans, Kep and Ve were generated from extended Tofts model and correlated with lymphoma subtype, Lugano staging and Ki-67 PI.</p><p><strong>Results: </strong>Mean Ktrans and Kep values were significantly higher in non-Hodgkin's lymphoma (NHL) than in Hodgkin's lymphoma (HL). Considering Ki-67 PI value of > 45% as aggressive lymphoma, the mean Ktrans (659.37 x 10-3min-1 versus 288.00 x 10-3min-1, p < 0.001) and Kep (1256.63 x 10-3min-1 versus 689.82 x 10-3min-1, p = 0.004) values in aggressive lymphomas were significantly higher compared to non-aggressive lymphomas. ROC curve analysis revealed a threshold Ktrans value of ≥ 359 x 10-3min-1 and Kep value of ≥ 853 x10-3 min-1 for diagnosing aggressive lymphomas with a sensitivity of 95%, 90%, specificity of 100%,82% and diagnostic accuracy of 91.7%,86.7% respectively. There was no significant difference in DCE-MRI parameters of various Lugano stage subgroups.</p><p><strong>Conclusion: </strong>DCE-MRI parameters have the potential to non-invasively predict the subtype, aggression and Ki-67 PI in nodal lymphoma.</p><p><strong>Advances in knowledge: </strong>The knowledge that Ktrans is higher in aggressive lymphomas is novel. It adds to previous literature regarding MR perfusion in various neoplasms.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143032297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diffusion weighted imaging to predict longer term response in Crohn's disease patients commencing biological therapy: Results from the MOTILITY Trial.","authors":"Maira Hameed, Stuart A Taylor, Norin Ahmed, Kashfia Chowdhury, Anisha Patel, Emma Helbren, Anisha Bhagwanani, Rachel Hyland, Gauraang Bhatnagar, Harbir Sidhu, Hannah Lambie, James Franklin, Maryam Mohsin, Elen Thomson, Darren Boone, Damian Tolan, Safi Rahman, Naomi S Sakai, Gordon W Moran, Alisa Hart, Stuart Bloom, Stuart Bloom, Alex Menys, Ilan Jacobs, Steve Halligan, Andrew A Plumb","doi":"10.1093/bjr/tqaf013","DOIUrl":"https://doi.org/10.1093/bjr/tqaf013","url":null,"abstract":"<p><strong>Objectives: </strong>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).</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p><p><strong>Advances in knowledge: </strong>Early post-induction DWI has no prognostic value for RoR at one year.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143032296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}