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Validation of the Simplified Magnetic Resonance Index of Activity [sMARIA] Without Gadolinium-enhanced Sequences for Crohn’s Disease
- Source :
- Journal of Crohn's and Colitis. 14:1074-1081
- Publication Year :
- 2020
- Publisher :
- Oxford University Press (OUP), 2020.
-
Abstract
- Background Gadolinium-enhanced sequences are not included in the simplified Magnetic Resonance Index of Activity [sMARIA], but in the derivation of this index readers had access to these sequences. The current study aimed to validate the sMARIA without gadolinium-enhanced sequences for assessing disease activity, severity, and response to treatment in patients with Crohn’s disease. Methods We prospectively included patients with active Crohn’s disease and at least one segment with severe inflammation [ulcers] at ileocolonoscopy, who required treatment with biologic drugs. Patients were evaluated by both magnetic resonance enterography [MRE] and ileocolonoscopy at baseline and 46 weeks after initiation of medical treatment. We compared the quantification of disease activity and response to treatment with sMARIA versus with ileocolonoscopy Crohn’s Disease Index of Severity [CDEIS], considered the gold standard. Results Data from both MRE and ileocolonoscopy 46 weeks after treatment initiation were available for 39 of the 50 patients. As in the derivation study, the optimal cutoffs were sMARIA ≥1 for predicting active disease (area under the curve [AUC] 0.92) and sMARIA ≥2 for predicting the presence of ulcers at ileocolonoscopy [AUC 0.93]. In evaluating the response to treatment, the sMARIA detected endoscopic ulcer healing at the segment level [sMARIA Conclusions The sMARIA is accurate and reliable in quantifying disease activity and response to treatment in luminal Crohn’s disease, without the need for gadolinium-enhanced sequences.
- Subjects :
- Adult
Male
medicine.medical_specialty
Gadolinium
chemistry.chemical_element
Disease
Severity of Illness Index
Gastroenterology
03 medical and health sciences
0302 clinical medicine
Crohn Disease
Internal medicine
Outcome Assessment, Health Care
Humans
Medicine
Derivation
Inflammation
Biological Products
Crohn's disease
medicine.diagnostic_test
business.industry
Patient Acuity
Area under the curve
Magnetic resonance imaging
Colonoscopy
General Medicine
Gold standard (test)
medicine.disease
Magnetic Resonance Imaging
Endoscopy
Immunity, Active
chemistry
030220 oncology & carcinogenesis
Female
Tumor Necrosis Factor Inhibitors
030211 gastroenterology & hepatology
Immunotherapy
business
Subjects
Details
- ISSN :
- 18764479 and 18739946
- Volume :
- 14
- Database :
- OpenAIRE
- Journal :
- Journal of Crohn's and Colitis
- Accession number :
- edsair.doi.dedup.....5a07639f1a572949a039397b559f7f3f
- Full Text :
- https://doi.org/10.1093/ecco-jcc/jjaa030