Marie-Lise Thierry1, Hélène Rousseau2, Lieven Pouillon1,3, Mélanie Girard-Gavanier4, Cédric Baumann2, Anthony Lopez1, Silvio Danese5, Valérie Laurent4, Laurent Peyrin-Biroulet1. 1. INSERM U954 and Department of Hepato-Gastroenterology, Nancy University Hospital, Vandoeuvre-lès-Nancy, France. 2. Clinical Research Support Facility PARC, UMDS, Nancy University Hospital, Vandoeuvre-lès-Nancy, France. 3. Imelda GI Clinical Research Centre, Imeldaziekenhuis Bonheiden, Bonheiden, Belgium. 4. INSERM U947 and Department of Radiology, Nancy University Hospital, Vandoeuvre-lès-Nancy, France. 5. Department of Gastroenterology, Humanitas Research Hospital, Milan, Italy.
Abstract
BACKGROUND AND AIMS: The Nancy score is a luminal Crohn's disease [CD] activity index applied in diffusion-weighted magnetic resonance imaging [DW-MRI]. We assessed the accuracy of the Nancy score in detecting mucosal healing and treatment response, and in predicting surgery. METHODS: This was a retrospective, single-centre study of all patients with active CD and serial DW-MRI before and after treatment initiation with a biologic drug, between January 2010 and September 2016. The gold standard was endoscopy. The association between the Nancy score and the cumulative probability of intestinal resection during follow-up was tested combining Kaplan-Meier curves and log-rank testing. RESULTS: A total of 96 patients were included; 20 had concomitantly undergone endoscopy. The Nancy score correlated well with the Crohn's Disease Endoscopic Index of Severity [r = 0.60 for the total score and r = 0.63 for the segmental score]. A total Nancy score <6 and a segmental Nancy score <2 detected mucosal healing with an area under the receiver operating characteristic curve [AUROC] of 0.82 (95% confidence interval [CI] 0.69-0.94, p <0.0001) and 0.80 [95% CI 0.73-0.87, p <0.0001], respectively. The Nancy score was highly sensitive to changes [Guyatt's responsiveness indices: 1.18 for the total score and 0.85 for the segmental score]. Mucosal healing on DW-MRI after treatment initiation was associated with a lower cumulative probability of intestinal surgery (p = 0.0251, median [interquartile range: IQR] follow-up 2.2 [1.6-3.7] years). CONCLUSIONS: In CD, the Nancy score accurately detects mucosal healing and treatment response, the latter associated with a lower likelihood of intestinal resection.
BACKGROUND AND AIMS: The Nancy score is a luminal Crohn's disease [CD] activity index applied in diffusion-weighted magnetic resonance imaging [DW-MRI]. We assessed the accuracy of the Nancy score in detecting mucosal healing and treatment response, and in predicting surgery. METHODS: This was a retrospective, single-centre study of all patients with active CD and serial DW-MRI before and after treatment initiation with a biologic drug, between January 2010 and September 2016. The gold standard was endoscopy. The association between the Nancy score and the cumulative probability of intestinal resection during follow-up was tested combining Kaplan-Meier curves and log-rank testing. RESULTS: A total of 96 patients were included; 20 had concomitantly undergone endoscopy. The Nancy score correlated well with the Crohn's Disease Endoscopic Index of Severity [r = 0.60 for the total score and r = 0.63 for the segmental score]. A total Nancy score <6 and a segmental Nancy score <2 detected mucosal healing with an area under the receiver operating characteristic curve [AUROC] of 0.82 (95% confidence interval [CI] 0.69-0.94, p <0.0001) and 0.80 [95% CI 0.73-0.87, p <0.0001], respectively. The Nancy score was highly sensitive to changes [Guyatt's responsiveness indices: 1.18 for the total score and 0.85 for the segmental score]. Mucosal healing on DW-MRI after treatment initiation was associated with a lower cumulative probability of intestinal surgery (p = 0.0251, median [interquartile range: IQR] follow-up 2.2 [1.6-3.7] years). CONCLUSIONS: In CD, the Nancy score accurately detects mucosal healing and treatment response, the latter associated with a lower likelihood of intestinal resection.
Authors: Katia Farias E Silva; Hayandra F Nanini; Cynthia Machado Cascabulho; Siane L B Rosas; Patricia T Santana; Antonio José de V Carneiro; Elias Anaissie; Marcio Nucci; Heitor Siffert Pereira de Souza Journal: World J Gastroenterol Date: 2021-03-07 Impact factor: 5.742
Authors: Jiyeon Ha; Seong Ho Park; Jung Hee Son; Ji Hun Kang; Byong Duk Ye; So Hyun Park; Bohyun Kim; Sang Hyun Choi; Sang Hyoung Park; Suk-Kyun Yang Journal: Korean J Radiol Date: 2021-09-13 Impact factor: 3.500