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, Alex Menys, Ilan Jacobs, Steve Halligan, Andrew A Plumb
{"title":"弥散加权成像预测开始生物治疗的克罗恩病患者的长期反应:来自MOTILITY试验的结果","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, Alex Menys, Ilan Jacobs, Steve Halligan, Andrew A Plumb","doi":"10.1093/bjr/tqaf013","DOIUrl":null,"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 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).</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p><p><strong>Advances in knowledge: </strong>Early post-induction DWI has no prognostic value for RoR at 1 year.</p>","PeriodicalId":9306,"journal":{"name":"British Journal of Radiology","volume":" ","pages":"527-534"},"PeriodicalIF":3.4000,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11919076/pdf/","citationCount":"0","resultStr":"{\"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, Alex Menys, Ilan Jacobs, Steve Halligan, Andrew A Plumb\",\"doi\":\"10.1093/bjr/tqaf013\",\"DOIUrl\":null,\"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 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).</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p><p><strong>Advances in knowledge: </strong>Early post-induction DWI has no prognostic value for RoR at 1 year.</p>\",\"PeriodicalId\":9306,\"journal\":{\"name\":\"British Journal of Radiology\",\"volume\":\" \",\"pages\":\"527-534\"},\"PeriodicalIF\":3.4000,\"publicationDate\":\"2025-04-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11919076/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"British Journal of Radiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1093/bjr/tqaf013\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"British Journal of Radiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/bjr/tqaf013","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
Diffusion-weighted imaging to predict longer-term response in Crohn's disease patients commencing biological therapy: results from the MOTILITY trial.
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.
期刊介绍:
BJR is the international research journal of the British Institute of Radiology and is the oldest scientific journal in the field of radiology and related sciences.
Dating back to 1896, BJR’s history is radiology’s history, and the journal has featured some landmark papers such as the first description of Computed Tomography "Computerized transverse axial tomography" by Godfrey Hounsfield in 1973. A valuable historical resource, the complete BJR archive has been digitized from 1896.
Quick Facts:
- 2015 Impact Factor – 1.840
- Receipt to first decision – average of 6 weeks
- Acceptance to online publication – average of 3 weeks
- ISSN: 0007-1285
- eISSN: 1748-880X
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