Fibrosis and MAGNIFI-CD Activity Index at Magnetic Resonance Imaging to Predict Treatment Outcome in Perianal Fistulizing Crohn's Disease Patients
| Autor: | Harmanna J Snijder, Karin Horsthuis, Patrick M.M. Bossuyt, Elise M Meima-van Praag, Christianne J. Buskens, Krisztina B Gecse, Kyra L. van Rijn, Geert R. D'Haens, Jeroen A. W. Tielbeek, Jaap Stoker |
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| Přispěvatelé: | Radiology and Nuclear Medicine, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, Graduate School, Surgery, Epidemiology and Data Science, APH - Methodology, APH - Personalized Medicine, Gastroenterology and Hepatology, Radiology and nuclear medicine |
| Jazyk: | angličtina |
| Rok vydání: | 2022 |
| Předmět: |
Anal fistula
Adult medicine.medical_specialty Fistula Cutaneous Fistula Palpation Crohn Disease Fibrosis medicine Humans Rectal Fistula magnetic resonance imaging Retrospective Studies Crohn's disease medicine.diagnostic_test Receiver operating characteristic business.industry Tumor Necrosis Factor-alpha Gastroenterology Area under the curve Magnetic resonance imaging General Medicine medicine.disease Treatment Outcome Female Tumor Necrosis Factor Inhibitors Radiology business |
| Zdroj: | Journal of Crohn's & colitis, 16(5), 708-716. Elsevier van Rijn, K L, Meima-van Praag, E M, Bossuyt, P M, D'Haens, G R, Gecse, K B, Horsthuis, K, Snijder, H J, Tielbeek, J A W, Buskens, C J & Stoker, J 2022, ' Fibrosis and MAGNIFI-CD Activity Index at Magnetic Resonance Imaging to Predict Treatment Outcome in Perianal Fistulizing Crohn's Disease Patients ', Journal of Crohn's & colitis, vol. 16, no. 5, pp. 708-716 . https://doi.org/10.1093/ecco-jcc/jjab168 |
| ISSN: | 1873-9946 |
| DOI: | 10.1093/ecco-jcc/jjab168 |
| Popis: | Background and Aims Characteristic magnetic resonance imaging [MRI] features associated with long-term perianal fistula closure are still being discussed. This study evaluated the predictive value of degree of fibrosis and disease activity (MAGNIFI-CD index) at MRI for long-term clinical closure of Crohn’s perianal fistulas. Methods Crohn’s disease [CD] patients treated with surgical closure following anti-tumour necrosis factor [anti-TNF] induction or anti-TNF alone for high perianal fistulas as part of a patient preference randomized controlled trial [PISA-II] between 2013 and 2020 with a post-treatment MRI and long-term clinical follow-up data were retrospectively included. Two radiologists scored the degree of fibrosis and MAGNIFI-CD index at pre- and post-treatment MRI. The accuracy of post-treatment MRI findings in predicting long-term clinical closure [12 months after the MRI] was evaluated using receiver operating characteristics [ROC] analysis. Results Fifty patients were included: 31 female, median age 33 years (interquartile range [IQR] 26–45). Fourteen patients showed a 100% fibrotic fistula at post-treatment MRI, all of which had long-term clinical closure. Median MAGNIFI-CD index at post-treatment MRI was 0 [IQR 0–5] in 25 patients with long-term clinical closure and 16 [IQR 10-20] in 25 patients without. ROC analysis showed an area under the curve of 0.90 (95% confidence interval [CI] 0.82–0.99) for degree of fibrosis and 0.95 [95% CI 0.89–1.00] for the MAGNIFI-CD index, with a Youden cut-off point of 6 [91% specificity, 87% sensitivity]. Conclusions Degree of fibrosis and MAGNIFI-CD index at post-treatment MRI are accurate in predicting long-term clinical closure and seem valuable in follow-up of perianal CD. A completely fibrotic tract at MRI is a robust indicator for long-term fistula closure. EudraCT 2013-002932-25 and 2018-002064-15 |
| Databáze: | OpenAIRE |
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