BACKGROUND AND AIMS: The aim of this study was to compare the accuracy and clinical impact of hybrid positron emission tomography [PET]/magnetic resonance-enterography [MR-E] and PET/computed tomography-enterography [CT-E] in patients with Crohn's disease [CD]. METHODS: A total of 35 patients with symptomatic small-bowel CD who were scheduled to undergo operation were evaluated before operation by same-day PET/CT-E and PET/MR-E. PET/MR-E was also compared with MR-E alone. Imaging accuracy for detecting pathological sites and discriminating between fibrotic and inflammatory strictures was assessed. Treatment was adjusted according to imaging findings and change in medical/surgical strategy was also evaluated. RESULTS: PET/CT-E, PET/MR-E, and MR-E were equally accurate in detecting CD sites. PET/MR-E was more accurate in assessing extra-luminal disease [p = 0.002], which was associated with higher need for stoma [p = 0.022] and distant localisation [p = 0.002]. When the latter was observed, laparoscopy was started with hand-assisted device, reducing operative time [p = 0.022]. PET/MR-E was also more accurate in detecting a fibrotic component compared with PET/CT-E [p = 0.043] and with MR-E [p = 0.024]. Fibrosis was more frequently classified as inflammation with MR-E compared with PET/MR-E [p = 0.019]. Out of 8 patients with predominantly inflammatory CD who received medical treatment, 6 [75%] remained surgery free. Overall, 29 patients received surgery. At median follow-up of 9 [6-22] months, no recurrences occurred in either the medical or the surgical group. CONCLUSIONS: Preoperative PET/MR-E imaging is highly accurate for assessing CD lesions before operation and contributed to clinical management of patients with small-bowel CD more often than PET/CT-E.

PET/MR versus PET/CT imaging: Impact on the clinical management of small-bowel Crohn's disease / Pellino, Gianluca; Nicolai, Emanuele; Catalano, Onofrio A; Campione, Severo; D'Armiento, FRANCESCO PAOLO; Salvatore, Marco; Cuocolo, Alberto; Selvaggi, Francesco. - In: JOURNAL OF CROHN'S AND COLITIS. - ISSN 1873-9946. - 10:3(2016), pp. 277-285. [10.1093/ecco-jcc/jjv207]

PET/MR versus PET/CT imaging: Impact on the clinical management of small-bowel Crohn's disease

CAMPIONE, SEVERO;D'ARMIENTO, FRANCESCO PAOLO;CUOCOLO, ALBERTO;
2016

Abstract

BACKGROUND AND AIMS: The aim of this study was to compare the accuracy and clinical impact of hybrid positron emission tomography [PET]/magnetic resonance-enterography [MR-E] and PET/computed tomography-enterography [CT-E] in patients with Crohn's disease [CD]. METHODS: A total of 35 patients with symptomatic small-bowel CD who were scheduled to undergo operation were evaluated before operation by same-day PET/CT-E and PET/MR-E. PET/MR-E was also compared with MR-E alone. Imaging accuracy for detecting pathological sites and discriminating between fibrotic and inflammatory strictures was assessed. Treatment was adjusted according to imaging findings and change in medical/surgical strategy was also evaluated. RESULTS: PET/CT-E, PET/MR-E, and MR-E were equally accurate in detecting CD sites. PET/MR-E was more accurate in assessing extra-luminal disease [p = 0.002], which was associated with higher need for stoma [p = 0.022] and distant localisation [p = 0.002]. When the latter was observed, laparoscopy was started with hand-assisted device, reducing operative time [p = 0.022]. PET/MR-E was also more accurate in detecting a fibrotic component compared with PET/CT-E [p = 0.043] and with MR-E [p = 0.024]. Fibrosis was more frequently classified as inflammation with MR-E compared with PET/MR-E [p = 0.019]. Out of 8 patients with predominantly inflammatory CD who received medical treatment, 6 [75%] remained surgery free. Overall, 29 patients received surgery. At median follow-up of 9 [6-22] months, no recurrences occurred in either the medical or the surgical group. CONCLUSIONS: Preoperative PET/MR-E imaging is highly accurate for assessing CD lesions before operation and contributed to clinical management of patients with small-bowel CD more often than PET/CT-E.
2016
PET/MR versus PET/CT imaging: Impact on the clinical management of small-bowel Crohn's disease / Pellino, Gianluca; Nicolai, Emanuele; Catalano, Onofrio A; Campione, Severo; D'Armiento, FRANCESCO PAOLO; Salvatore, Marco; Cuocolo, Alberto; Selvaggi, Francesco. - In: JOURNAL OF CROHN'S AND COLITIS. - ISSN 1873-9946. - 10:3(2016), pp. 277-285. [10.1093/ecco-jcc/jjv207]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11588/635915
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