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European Journal of Nuclear Medicine and Molecular Imaging

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01-04-2020 | Ileocolonoscopy | Original Article

¹⁸F-FDG PET-MR enterography in predicting histological active disease using the Nancy index in ulcerative colitis: a randomized controlled trial

Authors: Yan Li, Benedikt Schaarschmidt, Lale Umutlu, Michael Forsting, Aydin Demircioglu, Anna Katharina Koch, Ole Martin, Ken Herrmann, Hendrik Juette, Andrea Tannapfel, Jost Langhorst

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 4/2020

Abstract

Purpose

To evaluate the diagnostic performance of PET-MR enterography in detecting histological active inflammation in patients with ulcerative colitis and the impact of bowel purgation on diagnostic accuracies of PET-MR parameters.

Methods

Fifty patients were enrolled in this randomized controlled trial (clinicaltrials.gov [NCT03781284]). Forty patients were randomized in two study arms, in which bowel purgation was performed either before or after PET-MR enterography. All patients underwent ileocolonoscopy with mucosal biopsies after PET-MR within 24 h. Diagnostic performance of MR morphological parameters (MRmorph), diffusion-weighted imaging (DWI), and PET in detecting histological inflammation determined by the Nancy index was compared with each other and between study arms. Correlation between PET and histological inflammatory severity was calculated.

Results

In study arm without previous bowel purgation, SUV_max ratio of bowel segment (relative to SUV_max of the liver) facilitated the highest specificity and diagnostic accuracy compared with MRmorph and DWI. Bowel cleansing led to markedly increased metabolic activity of bowel segments, resulting in significantly reduced specificity of PET compared with study arm without purgation (0.808 vs. 0.966, p = 0.007, respectively). Inter-observer concordance for assessing MRmorph was clearly increased after bowel cleansing (Cohen’s κ, 0.847 vs. 0.665; p = 0.013, respectively), though diagnostic performance of MRmorph was not significantly improved. Our findings suggested that the change of metabolic status was mainly associated with the grade of neutrophil infiltrate and less dependent on chronic infiltrate.

Conclusion

PET-MR enterography was an excellent non-invasive diagnostic method in the assessment of histological active inflammation in ulcerative colitis without the need of previous bowel purgation.

Trial registration

https://clinicaltrials.gov/ct2/show/NCT03781284

Available only for authorised users

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Title: 18F-FDG PET-MR enterography in predicting histological active disease using the Nancy index in ulcerative colitis: a randomized controlled trial
Authors: Yan Li
Benedikt Schaarschmidt
Lale Umutlu
Michael Forsting
Aydin Demircioglu
Anna Katharina Koch
Ole Martin
Ken Herrmann
Hendrik Juette
Andrea Tannapfel
Jost Langhorst
Publication date: 01-04-2020
Publisher: Springer Berlin Heidelberg
Keywords: Ileocolonoscopy
Ulcerative Colitis
Chronic Inflammatory Bowel Disease
Published in: European Journal of Nuclear Medicine and Molecular Imaging / Issue 4/2020
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-019-04535-w

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

¹⁸F-FDG PET-MR enterography in predicting histological active disease using the Nancy index in ulcerative colitis: a randomized controlled trial

Abstract

Purpose

Methods

Results

Conclusion

Trial registration

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Trial registration

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