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Hanžel J, Jairath V, Ma C, Guizzetti L, Zou G, Santillan CS, Taylor SA, van Viegen T, D'Haens GR, Feagan BG, Panés J, Rimola J. Responsiveness of Magnetic Resonance Enterography Indices for Evaluation of Luminal Disease Activity in Crohn's Disease. Clin Gastroenterol Hepatol 2022; 20:2598-2606. [PMID: 35149220 DOI: 10.1016/j.cgh.2022.01.055] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 12/20/2021] [Accepted: 01/31/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Magnetic resonance enterography (MRE) is having an increasing role in Crohn's disease; however, fully validated indices are needed. We evaluated the responsiveness of 4 MRE indices in luminal Crohn's disease. METHODS Paired MRE images (pretreatment and post-treatment at weeks 12 or 14) from 41 patients were scored by 3 blinded radiologists. Disease activity was scored for 4 MRE indices (magnetic resonance index of activity [MaRIA], simplified MaRIA, London index, and London extended index) and a 100-mm visual analog scale (VAS) of overall disease activity. The criterion for change was an improvement by at least one half of an SD in the VAS after treatment. Responsiveness was evaluated using the standardized effect size (SES). Longitudinal validity was evaluated using correlations between changes in MRE index scores and disease activity measures including endoscopy and the VAS. RESULTS The SES was 1.17 (95% CI, 0.56-1.77) for the simplified MaRIA, 0.98 (95% CI, 0.42-1.55) for the MaRIA, 0.95 (95% CI, 0.38-1.51) for the London extended index, and 0.85 (95% CI, 0.31-1.39) for the London index. The simplified MaRIA was significantly more responsive than the London index (ΔSES, 0.32; 95% CI, 0.05-0.58) but not the MaRIA (ΔSES, 0.18; 95% CI, -0.01 to 0.38) or the London extended index (ΔSES, 0.22; 95% CI, -0.05 to 0.50). Correlations with endoscopy (simplified MaRIA: r = 0.72) were not different from correlations with the VAS (London extended index: r = 0.70). CONCLUSIONS Evaluated MRE indices showed moderate-to-large responsiveness and are suitable for use in clinical trials. The simplified MaRIA may be preferred because of its responsiveness and nonreliance on gadolinium administration.
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Affiliation(s)
- Jurij Hanžel
- Department of Gastroenterology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia; Alimentiv, Inc, London, Ontario, Canada; Department of Gastroenterology and Hepatology, Amsterdam University Medical Centre, Academic Medical Centre, Amsterdam, The Netherlands
| | - Vipul Jairath
- Alimentiv, Inc, London, Ontario, Canada; Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada; Division of Gastroenterology, Western University, London, Ontario, Canada.
| | - Christopher Ma
- Alimentiv, Inc, London, Ontario, Canada; Division of Gastroenterology and Hepatology, University of Calgary, Calgary, Alberta, Canada
| | | | - Guangyong Zou
- Alimentiv, Inc, London, Ontario, Canada; Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada; Robarts Research Institute, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Cynthia S Santillan
- Department of Radiology, University of California San Diego, La Jolla, California
| | - Stuart A Taylor
- Centre for Medical Imaging, University College London, London, United Kingdom
| | | | - Geert R D'Haens
- Alimentiv, Inc, London, Ontario, Canada; Department of Gastroenterology and Hepatology, Amsterdam University Medical Centre, Academic Medical Centre, Amsterdam, The Netherlands
| | - Brian G Feagan
- Alimentiv, Inc, London, Ontario, Canada; Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada; Division of Gastroenterology, Western University, London, Ontario, Canada
| | - Julián Panés
- Hospital Clinic Barcelona, August Pi i Sunyer Biomedical Research Institute, Centro de Investigación Biomédica en Red Enfermedades Hepáticas y Digestivas, Barcelona, Spain
| | - Jordi Rimola
- Hospital Clinic Barcelona, August Pi i Sunyer Biomedical Research Institute, Centro de Investigación Biomédica en Red Enfermedades Hepáticas y Digestivas, Barcelona, Spain
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