@inproceedings{8770508,
  abstract     = {{Introduction: Differentiation between inflammatory and fibrotic bowel strictures remains a holy grail in Crohn’s disease (CD) management, primarily because of the therapeutic implications. Stricture characterisation in CD patients is further hampered by the co-occurrence of inflammation and fibrosis in various degrees. Currently, there are no validated imaging tools to differentiate fibrotic from inflammatory or mixed strictures, but several new techniques, such as magnetization transfer magnetic resonance imaging (MT-MRI) and magnetic resonance texture analysis (MR-TA), seem promising.
Aims & Methods: To investigate these possible new imaging techniques for stricture management, we assessed the performance of magnetization transfer (MT) magnetic resonance imaging (MRI) and texture analysis (TA) of T2-weighted images. Temporal MT and T2-weighted magnetic resonance (MR) images were correlated with histology as the gold standard in a model of gut fibrosis resulting from chronic colitis induced in C57BL/6J mice by cyclic administration of dextran sulfate sodium. The performance of MT-MRI and TA was validated in the same model with an antifibrotic therapy administrated to one group of mice. To check the translatability of the results, MR enterography images of patients with CD who underwent bowel surgery were retrospectively analyzed and matched with histopathology.
Results: The MT-MRI and TA entropy correlated with fibrosis on the histopathology (r=.85 and .81, respectively). However, TA entropy was superior to the MT-MRI for quantifying the progression of fibrosis (linear regressionR²=.93) because the MT-MRI signal was severely biased due to coexisting inflammation. The effect of the successful antifibrotic therapy was efficiently captured using TA entropy. Finally, TA entropy was a valid parameter to detect and grade intestinal fibrosis in axial T2-weighted MR images of patients with CD.
Conclusion: Based on the applied model of relapsing-remitting colitis, which allowed the study of coexisting inflammation and progressive fibrosis, we demonstrated that although MT-MRI and TA entropy are highly promising surrogate markers of intestinal fibrosis, TA entropy performed better in monitoring and quantifying fibrotic lesions in the presence of concomitant inflammation.}},
  author       = {{Bos, Simon and De Kock, Isabelle and Van Welden, Sophie and Bunyard, Peter and Hindryckx, Pieter and De Vos, Martine and Villeirs, Geert and Laukens, Debby}},
  booktitle    = {{UEG Week 2022, Abstracts}},
  keywords     = {{Fibrosis,MRI,Texture analysis}},
  language     = {{eng}},
  location     = {{Vienna, Austria}},
  title        = {{Magnetic resonance texture analysis is superior to magnetization transfer imaging for longitudinal assessment of fibrosis in experimental colitis}},
  url          = {{https://programme.ueg.eu/week2022/#/details/presentations/1508}},
  year         = {{2022}},
}