Findings of ulceration and severe stricture on MRE can predict prognosis of Crohn’s disease in patients treated with anti-TNF treatment

Makoto Naganuma, Shigeo Okuda, Tadakazu Hisamatsu, Katsuyoshi Matsuoka, Kiyoto Mori, Naoki Hosoe, Yoshihiro Nakazato, Haruhiko Ogata, Takanori Kanai

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background: MR enterography (MRE) is useful for evaluating transmural lesions and extra-intestinal complications of Crohn’s disease (CD). The aim of this study was to prospectively evaluate whether MRE could detect severe strictures and inflammatory lesions in patients who lost the responsiveness to anti-TNF treatment and whether MRE could predict prognosis of CD patients with clinical remission. Patients and methods: MRE were conducted in 50 patients who were treated with infliximab or adalimumab. The main aims of this study were as follows; (1) to compare the rates of CD lesions of the patients with clinical remission and active disease at the baseline and (2) to assess the MRE findings that were predictors of clinical recurrence among patients with clinical remission at the baseline. Results: The MRE detection rates of markedly increased contrast uptake, severe strictures, and the presence of ulcers were significantly higher in patients with Crohn Disease Activity Index ≥150 than in patients with clinical remission. Over a mean follow-up of 18.2 months, the absence of ulceration (p = 0.001) or severe stricture (p = 0.01) prolonged clinical recurrence among patients with clinical remission at baseline. Expected duration of recurrence significantly prolonged in patients with total magnetic resonance index of activity (MaRIA) <36.3 [29.8 months (95% CI 23.7–35.9)] than in patients with total MaRIA ≥36.3 (13.9 months (95% CI 7.7–20.1). A cut-off value of total MaRIA score of 36.3 had a sensitivity of 75% and specificity of 70% for predicting recurrence. Conclusion: Findings of ulceration and severe stricture on MRE predict prognosis of CD patients who were treated with anti-TNF treatment. MRE might be useful for making treatment decisions in patients who lost the effectiveness of medical treatments.

Original languageEnglish
Pages (from-to)1-11
Number of pages11
JournalAbdominal Radiology
DOIs
Publication statusAccepted/In press - 2016 Aug 23

Fingerprint

Crohn Disease
Pathologic Constriction
Therapeutics
Recurrence
Magnetic Resonance Spectroscopy
Ulcer
Decision Making
Sensitivity and Specificity

Keywords

  • Anti-TNF treatment
  • Crohn’s disease
  • MR enterography

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology
  • Urology
  • Radiological and Ultrasound Technology

Cite this

Findings of ulceration and severe stricture on MRE can predict prognosis of Crohn’s disease in patients treated with anti-TNF treatment. / Naganuma, Makoto; Okuda, Shigeo; Hisamatsu, Tadakazu; Matsuoka, Katsuyoshi; Mori, Kiyoto; Hosoe, Naoki; Nakazato, Yoshihiro; Ogata, Haruhiko; Kanai, Takanori.

In: Abdominal Radiology, 23.08.2016, p. 1-11.

Research output: Contribution to journalArticle

@article{0b780b40e2b34f428139570ee27c4265,
title = "Findings of ulceration and severe stricture on MRE can predict prognosis of Crohn’s disease in patients treated with anti-TNF treatment",
abstract = "Background: MR enterography (MRE) is useful for evaluating transmural lesions and extra-intestinal complications of Crohn’s disease (CD). The aim of this study was to prospectively evaluate whether MRE could detect severe strictures and inflammatory lesions in patients who lost the responsiveness to anti-TNF treatment and whether MRE could predict prognosis of CD patients with clinical remission. Patients and methods: MRE were conducted in 50 patients who were treated with infliximab or adalimumab. The main aims of this study were as follows; (1) to compare the rates of CD lesions of the patients with clinical remission and active disease at the baseline and (2) to assess the MRE findings that were predictors of clinical recurrence among patients with clinical remission at the baseline. Results: The MRE detection rates of markedly increased contrast uptake, severe strictures, and the presence of ulcers were significantly higher in patients with Crohn Disease Activity Index ≥150 than in patients with clinical remission. Over a mean follow-up of 18.2 months, the absence of ulceration (p = 0.001) or severe stricture (p = 0.01) prolonged clinical recurrence among patients with clinical remission at baseline. Expected duration of recurrence significantly prolonged in patients with total magnetic resonance index of activity (MaRIA) <36.3 [29.8 months (95{\%} CI 23.7–35.9)] than in patients with total MaRIA ≥36.3 (13.9 months (95{\%} CI 7.7–20.1). A cut-off value of total MaRIA score of 36.3 had a sensitivity of 75{\%} and specificity of 70{\%} for predicting recurrence. Conclusion: Findings of ulceration and severe stricture on MRE predict prognosis of CD patients who were treated with anti-TNF treatment. MRE might be useful for making treatment decisions in patients who lost the effectiveness of medical treatments.",
keywords = "Anti-TNF treatment, Crohn’s disease, MR enterography",
author = "Makoto Naganuma and Shigeo Okuda and Tadakazu Hisamatsu and Katsuyoshi Matsuoka and Kiyoto Mori and Naoki Hosoe and Yoshihiro Nakazato and Haruhiko Ogata and Takanori Kanai",
year = "2016",
month = "8",
day = "23",
doi = "10.1007/s00261-016-0878-5",
language = "English",
pages = "1--11",
journal = "Abdominal Radiology",
issn = "2366-004X",
publisher = "Springer New York",

}

TY - JOUR

T1 - Findings of ulceration and severe stricture on MRE can predict prognosis of Crohn’s disease in patients treated with anti-TNF treatment

AU - Naganuma, Makoto

AU - Okuda, Shigeo

AU - Hisamatsu, Tadakazu

AU - Matsuoka, Katsuyoshi

AU - Mori, Kiyoto

AU - Hosoe, Naoki

AU - Nakazato, Yoshihiro

AU - Ogata, Haruhiko

AU - Kanai, Takanori

PY - 2016/8/23

Y1 - 2016/8/23

N2 - Background: MR enterography (MRE) is useful for evaluating transmural lesions and extra-intestinal complications of Crohn’s disease (CD). The aim of this study was to prospectively evaluate whether MRE could detect severe strictures and inflammatory lesions in patients who lost the responsiveness to anti-TNF treatment and whether MRE could predict prognosis of CD patients with clinical remission. Patients and methods: MRE were conducted in 50 patients who were treated with infliximab or adalimumab. The main aims of this study were as follows; (1) to compare the rates of CD lesions of the patients with clinical remission and active disease at the baseline and (2) to assess the MRE findings that were predictors of clinical recurrence among patients with clinical remission at the baseline. Results: The MRE detection rates of markedly increased contrast uptake, severe strictures, and the presence of ulcers were significantly higher in patients with Crohn Disease Activity Index ≥150 than in patients with clinical remission. Over a mean follow-up of 18.2 months, the absence of ulceration (p = 0.001) or severe stricture (p = 0.01) prolonged clinical recurrence among patients with clinical remission at baseline. Expected duration of recurrence significantly prolonged in patients with total magnetic resonance index of activity (MaRIA) <36.3 [29.8 months (95% CI 23.7–35.9)] than in patients with total MaRIA ≥36.3 (13.9 months (95% CI 7.7–20.1). A cut-off value of total MaRIA score of 36.3 had a sensitivity of 75% and specificity of 70% for predicting recurrence. Conclusion: Findings of ulceration and severe stricture on MRE predict prognosis of CD patients who were treated with anti-TNF treatment. MRE might be useful for making treatment decisions in patients who lost the effectiveness of medical treatments.

AB - Background: MR enterography (MRE) is useful for evaluating transmural lesions and extra-intestinal complications of Crohn’s disease (CD). The aim of this study was to prospectively evaluate whether MRE could detect severe strictures and inflammatory lesions in patients who lost the responsiveness to anti-TNF treatment and whether MRE could predict prognosis of CD patients with clinical remission. Patients and methods: MRE were conducted in 50 patients who were treated with infliximab or adalimumab. The main aims of this study were as follows; (1) to compare the rates of CD lesions of the patients with clinical remission and active disease at the baseline and (2) to assess the MRE findings that were predictors of clinical recurrence among patients with clinical remission at the baseline. Results: The MRE detection rates of markedly increased contrast uptake, severe strictures, and the presence of ulcers were significantly higher in patients with Crohn Disease Activity Index ≥150 than in patients with clinical remission. Over a mean follow-up of 18.2 months, the absence of ulceration (p = 0.001) or severe stricture (p = 0.01) prolonged clinical recurrence among patients with clinical remission at baseline. Expected duration of recurrence significantly prolonged in patients with total magnetic resonance index of activity (MaRIA) <36.3 [29.8 months (95% CI 23.7–35.9)] than in patients with total MaRIA ≥36.3 (13.9 months (95% CI 7.7–20.1). A cut-off value of total MaRIA score of 36.3 had a sensitivity of 75% and specificity of 70% for predicting recurrence. Conclusion: Findings of ulceration and severe stricture on MRE predict prognosis of CD patients who were treated with anti-TNF treatment. MRE might be useful for making treatment decisions in patients who lost the effectiveness of medical treatments.

KW - Anti-TNF treatment

KW - Crohn’s disease

KW - MR enterography

UR - http://www.scopus.com/inward/record.url?scp=84983260394&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84983260394&partnerID=8YFLogxK

U2 - 10.1007/s00261-016-0878-5

DO - 10.1007/s00261-016-0878-5

M3 - Article

C2 - 27549100

AN - SCOPUS:84983260394

SP - 1

EP - 11

JO - Abdominal Radiology

JF - Abdominal Radiology

SN - 2366-004X

ER -