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Magnetic resonance enterography accurately assesses response to therapy in Crohn's

The latest issue of Gastroenterology examines the accuracy of magnetic resonance enterography in assessing response to therapy and mucosal healing in patients with Crohn's disease. 

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Dr Julián Panés and colleagues from Spain assessed the accuracy of magnetic resonance enterography (MRE) in monitoring response to therapy in patients with Crohn’s disease (CD) using ileocolonoscopy as a reference standard.

The research team performed a prospective multicenter study of 48 patients with active CD and ulcers in at least 1 ileocolonic segment.

All patients underwent ileocolonoscopy and MRE at baseline and 12 weeks after completing treatment with corticosteroids (CS) or anti−tumor necrosis factor agents.

Disease activity was quantified using Crohn's Disease Endoscopic Index of Severity (CDEIS) and Magnetic Resonance Index of Activity (MaRIA).

MRE determined ulcer healing with 90% accuracy
Gastroenterology

The team's primary analysis was to determine the accuracy of MRE in identification of healing, defined as the disappearance of ulcers in endoscopy examination.

Additional analyses established the accuracy of MRE in determining endoscopic remission, and change in severity based on consideration of all segments.

The team found that MRE determined ulcer healing with 90% accuracy and endoscopic remission with 83% accuracy.

The research team observed that the mean CDEIS and MaRIA scores significantly changed at week 12 in segments with ulcer healing, based on endoscopic examination.

The MaRIA score accurately detected changes in lesion severity.

The researchers noted that MRE was as reliable as endoscopy in assessing healing.

No significant changes in CDEIS or MaRIA scores were observed in segments with persistent ulcers, based on endoscopic examination.

The team found that the magnitude of change in CDEIS scores correlated with those in MaRIA scores.

Dr Julián Panés' team comments, "MRE evaluates ulcer healing with a high level of accuracy when ileocolonoscopy is used as the reference standard."

"The MaRIA is a valid, responsive, and reliable index assessing response to therapy in patients with CD."

Gastroenterology 2014: 146(2): 374-382.e1
31 January 2014

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