BACKGROUND AND AIMS: Ultrasound elasticity imaging is a non-invasive technique developed to evaluate fibrosis. Measuring tissue strain by ultrasound elasticity imaging can reliably detect severe ileal fibrosis in patients with Crohn's disease [CD]. We have hypothesised that a more severe range of fibrosis might influence the therapeutic response to anti-tumour necrosis factor [TNF] treatment. The aim of this study was to assess the ability of ultrasound elasticity imaging to predict the therapeutic outcome for CD patients. METHODS: Consecutive patients with ileal/ileocolonic CD, starting anti-TNF treatment, were enrolled for the study. These patients underwent bowel ultrasound and ultrasound elasticity imaging at baseline and at 14 and 52 weeks after anti-TNF treatment. Bowel wall stiffness was quantified by calculating the strain ratio between the mesenteric tissue and the bowel wall. Strain ratio ≥ 2 was used to identify severe ileal fibrosis. Transmural healing at 14 and 52 weeks was defined as bowel wall thickness ≤ 3 mm. RESULTS: Thirty patients with CD were enrolled. Five patients underwent surgery for bowel obstruction. The frequency of surgeries was significantly greater in patients with a strain ratio ≥ 2 at baseline [p = 0.003]. A significant reduction of the bowel thickness was observed after 14 and 52 weeks of anti-TNF treatment [p < 0.005]. A significant inverse correlation was observed between the strain ratio values at baseline and the thickness variations following anti-TNF therapy [p = 0.007]; 27% of patients achieved transmural healing at 14 weeks. The baseline strain ratio was significantly lower in patients with transmural healing [p < 0.05]. CONCLUSIONS: This study shows that ultrasound elasticity imaging predicts therapeutic outcomes for CD patients treated with anti-TNF.
BACKGROUND AND AIMS: Ultrasound elasticity imaging is a non-invasive technique developed to evaluate fibrosis. Measuring tissue strain by ultrasound elasticity imaging can reliably detect severe ileal fibrosis in patients with Crohn's disease [CD]. We have hypothesised that a more severe range of fibrosis might influence the therapeutic response to anti-tumour necrosis factor [TNF] treatment. The aim of this study was to assess the ability of ultrasound elasticity imaging to predict the therapeutic outcome for CD patients. METHODS: Consecutive patients with ileal/ileocolonic CD, starting anti-TNF treatment, were enrolled for the study. These patients underwent bowel ultrasound and ultrasound elasticity imaging at baseline and at 14 and 52 weeks after anti-TNF treatment. Bowel wall stiffness was quantified by calculating the strain ratio between the mesenteric tissue and the bowel wall. Strain ratio ≥ 2 was used to identify severe ileal fibrosis. Transmural healing at 14 and 52 weeks was defined as bowel wall thickness ≤ 3 mm. RESULTS: Thirty patients with CD were enrolled. Five patients underwent surgery for bowel obstruction. The frequency of surgeries was significantly greater in patients with a strain ratio ≥ 2 at baseline [p = 0.003]. A significant reduction of the bowel thickness was observed after 14 and 52 weeks of anti-TNF treatment [p < 0.005]. A significant inverse correlation was observed between the strain ratio values at baseline and the thickness variations following anti-TNF therapy [p = 0.007]; 27% of patients achieved transmural healing at 14 weeks. The baseline strain ratio was significantly lower in patients with transmural healing [p < 0.05]. CONCLUSIONS: This study shows that ultrasound elasticity imaging predicts therapeutic outcomes for CD patients treated with anti-TNF.
Authors: Olga Maria Nardone; Giulio Calabrese; Anna Testa; Anna Caiazzo; Giuseppe Fierro; Antonio Rispo; Fabiana Castiglione Journal: Front Med (Lausanne) Date: 2022-05-23
Authors: Johan F K F Ilvemark; Tawnya Hansen; Thomas M Goodsall; Jakob B Seidelin; Heba Al-Farhan; Mariangela Allocca; Jakob Begun; Robert V Bryant; Dan Carter; Britt Christensen; Marla C Dubinsky; Krisztina B Gecse; Torsten Kucharzik; Cathy Lu; Christian Maaser; Giovanni Maconi; Kim Nylund; Carolina Palmela; Stephanie R Wilson; Kerri Novak; Rune Wilkens Journal: J Crohns Colitis Date: 2022-05-10 Impact factor: 10.020
Authors: Pierluigi Puca; Livio Enrico Del Vecchio; Maria Elena Ainora; Antonio Gasbarrini; Franco Scaldaferri; Maria Assunta Zocco Journal: Diagnostics (Basel) Date: 2022-08-17