Joy L Barber1,2, Alexsandra Zambrano-Perez3, Øystein E Olsen1, Fevronia Kiparissi3, Mila Baycheva3, Daniela Knaflez3, Neil Shah3, Tom A Watson4. 1. Department of Paediatric Radiology, Great Ormond Street Hospital NHS Foundation Trust, London, Wc1N 3JH, UK. 2. Department of Radiology, St. George's Hospital NHS Foundation Trust, London, UK. 3. Department of Paediatric Gastroenterology, Great Ormond Street Hospital NHS Foundation Trust, London, UK. 4. Department of Paediatric Radiology, Great Ormond Street Hospital NHS Foundation Trust, London, Wc1N 3JH, UK. Tom.watson@gosh.nhs.uk.
Abstract
BACKGROUND: Magnetic resonance enterography (MRE) is the current gold standard for imaging in inflammatory bowel disease, but ultrasound (US) is a potential alternative. OBJECTIVE: To determine whether US is as good as MRE for the detecting inflamed bowel, using a combined consensus score as the reference standard. MATERIALS AND METHODS: We conducted a retrospective cohort study in children and adolescents <18 years with inflammatory bowel disease (IBD) at a tertiary and quaternary centre. We included children who underwent MRE and US within 4 weeks. We scored MRE using the London score and US using a score adapted from the METRIC (MR Enterography or Ultrasound in Crohn's Disease) trial. Four gastroenterologists assessed an independent clinical consensus score. A combined consensus score using the imaging and clinical scores was agreed upon and used as the reference standard to compare MRE with US. RESULTS: We included 53 children. At a whole-patient level, MRE scores were 2% higher than US scores. We used Lin coefficient to assess inter-observer variability. The repeatability of MRE scores was poor (Lin 0.6). Agreement for US scoring was substantial (Lin 0.95). There was a significant positive correlation between MRE and clinical consensus scores (Spearman's rho = 0.598, P=0.0053) and US and clinical consensus scores (Spearman's rho = 0.657, P=0.0016). CONCLUSION: US detects as much clinically significant bowel disease as MRE. It is possible that MRE overestimates the presence of disease when using a scoring system. This study demonstrates the feasibility of using a clinical consensus reference standard in paediatric IBD imaging studies.
BACKGROUND: Magnetic resonance enterography (MRE) is the current gold standard for imaging in inflammatory bowel disease, but ultrasound (US) is a potential alternative. OBJECTIVE: To determine whether US is as good as MRE for the detecting inflamed bowel, using a combined consensus score as the reference standard. MATERIALS AND METHODS: We conducted a retrospective cohort study in children and adolescents <18 years with inflammatory bowel disease (IBD) at a tertiary and quaternary centre. We included children who underwent MRE and US within 4 weeks. We scored MRE using the London score and US using a score adapted from the METRIC (MR Enterography or Ultrasound in Crohn's Disease) trial. Four gastroenterologists assessed an independent clinical consensus score. A combined consensus score using the imaging and clinical scores was agreed upon and used as the reference standard to compare MRE with US. RESULTS: We included 53 children. At a whole-patient level, MRE scores were 2% higher than US scores. We used Lin coefficient to assess inter-observer variability. The repeatability of MRE scores was poor (Lin 0.6). Agreement for US scoring was substantial (Lin 0.95). There was a significant positive correlation between MRE and clinical consensus scores (Spearman's rho = 0.598, P=0.0053) and US and clinical consensus scores (Spearman's rho = 0.657, P=0.0016). CONCLUSION: US detects as much clinically significant bowel disease as MRE. It is possible that MRE overestimates the presence of disease when using a scoring system. This study demonstrates the feasibility of using a clinical consensus reference standard in paediatric IBD imaging studies.
Authors: Jesica C Makanyanga; Doug Pendsé; Nikolaos Dikaios; Stuart Bloom; Sara McCartney; Emma Helbren; Elaine Atkins; Terry Cuthbertson; Shonit Punwani; Alastair Forbes; Steve Halligan; Stuart A Taylor Journal: Eur Radiol Date: 2013-09-12 Impact factor: 5.315
Authors: Wallace Crandall; Michael D Kappelman; Richard B Colletti; Ian Leibowitz; John E Grunow; Sabina Ali; Howard I Baron; James H Berman; Brendan Boyle; Stanley Cohen; Fernando del Rosario; Lee A Denson; Lynn Duffy; Mark J Integlia; Sandra C Kim; David Milov; Ashish S Patel; Bess T Schoen; Dorota Walkiewicz; Peter Margolis Journal: Inflamm Bowel Dis Date: 2011-01 Impact factor: 5.325
Authors: D A Pendsé; J C Makanyanga; A A Plumb; G Bhatnagar; D Atkinson; Manuel Rodriguez-Justo; S Halligan; S A Taylor Journal: Abdom Radiol (NY) Date: 2017-01
Authors: Tom A Watson; Philippe Petit; Thomas A Augdal; E Fred Avni; Costanza Bruno; M Beatrice Damasio; Kassa Darge; Damjana Kjucevsek; Stéphanie Franchi-Abella; Donald Ibe; Annemieke Littooij; Luisa Lobo; Hans J Mentzel; Marcelo Napolitano; Aikaterini Ntoulia; Michael Riccabona; Samuel Stafrace; Magdalena Wozniak; Lil-Sofie Ording Müller Journal: Pediatr Radiol Date: 2019-05