Diffusion-weighted imaging to predict longer-term response in Crohn's disease patients commencing biological therapy: Results from the MOTILITY trial
Authors: Hameed, M., Taylor, S.A., Ahmed, N., Chowdhury, K., Patel, A., Helbren, E., Bhagwanani, A., Hyland, R., Bhatnagar, G., Sidhu, H., Lambie, H., Franklin, J., Mohsin, M., Thomson, E., Boone, D., Tolan, D., Rahman, S., Sakai, N.S., Moran, G.W., Hart, A., Bloom, S., Menys, A., Jacobs, I., Halligan, S., Plumb, A.A., Ahmad, T., Ahmed, S., Ahmed-Timms, F., Baldwin-Cleland, R., Chikkeragowda, U.B., Barratt, N., Beeston, T., Brezina, B., Cetroni, A., Choudhury, J., Cipriano, B., Dilawershah, M., Fitzke, H., Foster, T., Gangi, A., Gibbons, N., Godfrey, E., Gupta, A., Higginson, A., Holmes, J., Hosseini-Ardehali, F., Isaac, E., Jastrub, R., Joseph, M., Kaur, J., Kilic, Y., Kok, K.B., Kpodo, F., Kumar, S., Langlands, S., Loveday, E., McCartney, S., Mooney, P., Onoviran, F., Parkes, M., Patel, J., Patel, K., Patel, K., Patodi, N., Philpott, S., Pollok, R., Przemiosolo, R., Rafferty, H., Ramsami, J., Robinson, C., Roffe, S., Rogers, L., Rosiou, K., Seward, A., Theis, B., Thoua, N., Travis, S., Wadke, A., Ward, L., Wilce, A., Williams, S.
Journal: British Journal of Radiology
Publication Date: 01/04/2025
Volume: 98
Issue: 1168
Pages: 527-534
eISSN: 1748-880X
ISSN: 0007-1285
DOI: 10.1093/bjr/tqaf013
Abstract:Objectives: Predicting longer-term response to biological therapy for small bowel Crohn's disease (SBCD) is an unmet clinical need. Diffusion-weighted magnetic resonance (MR) imaging (DWI) may indicate disease activity, but its predictive ability, if any, is unknown. We investigated the prognostic value of DWI for 1 year response or remission (RoR) in SBCD patients commencing biologic therapy, including incremental value over C-reactive protein (CRP) and faecal calprotectin (FC). Methods: A subset of participants in a prospective, multicentre study investigating the predictive ability of motility MRI for 1-year RoR in patients starting biologic therapy for active SBCD, underwent additional DWI at baseline and post-induction (12-30 weeks). CRP and FC were collected in a subgroup. RoR at 1 year was evaluated using clinical and morphological MR enterography (MRE) parameters. We calculated sensitivity and specificity to predict RoR and quality of life (QoL) at 1 year, comparing apparent diffusion coefficient (ADC) value, Clermont score, and CRP using multivariable logistic regression. Results: A total of 25 participants were included (mean 36.9 years, 32% female). ADC changes and Clermont score had poor sensitivity (30.0% [95% CI, 6.7-65.2] and 40.0% [95% CI, 12.2-73.8], respectively) and poor-to-modest specificity (50.0 [95% CI, 27.2-72.8] and 65.0% [95% CI, 40.8-84.6]) for RoR. None of Clermont score, CRP, or FC predicted QoL. Conclusions: DWI has inadequate sensitivity and specificity for RoR at 1 year. There is no significant incremental prognostic value of DWI over CRP and FC to predict RoR and/or QoL at 1 year. Advances in knowledge: Early post-induction DWI has no prognostic value for RoR at 1 year.
https://eprints.bournemouth.ac.uk/40753/
Source: Scopus
Diffusion-weighted imaging to predict longer-term response in Crohn's disease patients commencing biological therapy: results from the MOTILITY trial.
Authors: Hameed, M., Taylor, S.A., Ahmed, N., Chowdhury, K., Patel, A., Helbren, E., Bhagwanani, A., Hyland, R., Bhatnagar, G., Sidhu, H., Lambie, H., Franklin, J., Mohsin, M., Thomson, E., Boone, D., Tolan, D., Rahman, S., Sakai, N.S., Moran, G.W., Hart, A., Bloom, S., Menys, A., Jacobs, I., Halligan, S., Plumb, A.A., MOTILITY Trial Investigators
Journal: Br J Radiol
Publication Date: 01/04/2025
Volume: 98
Issue: 1168
Pages: 527-534
eISSN: 1748-880X
DOI: 10.1093/bjr/tqaf013
Abstract:OBJECTIVES: Predicting longer-term response to biological therapy for small bowel Crohn's disease (SBCD) is an unmet clinical need. Diffusion-weighted magnetic resonance (MR) imaging (DWI) may indicate disease activity, but its predictive ability, if any, is unknown. We investigated the prognostic value of DWI for 1 year response or remission (RoR) in SBCD patients commencing biologic therapy, including incremental value over C-reactive protein (CRP) and faecal calprotectin (FC). METHODS: A subset of participants in a prospective, multicentre study investigating the predictive ability of motility MRI for 1-year RoR in patients starting biologic therapy for active SBCD, underwent additional DWI at baseline and post-induction (12-30 weeks). CRP and FC were collected in a subgroup. RoR at 1 year was evaluated using clinical and morphological MR enterography (MRE) parameters. We calculated sensitivity and specificity to predict RoR and quality of life (QoL) at 1 year, comparing apparent diffusion coefficient (ADC) value, Clermont score, and CRP using multivariable logistic regression. RESULTS: A total of 25 participants were included (mean 36.9 years, 32% female). ADC changes and Clermont score had poor sensitivity (30.0% [95% CI, 6.7-65.2] and 40.0% [95% CI, 12.2-73.8], respectively) and poor-to-modest specificity (50.0 [95% CI, 27.2-72.8] and 65.0% [95% CI, 40.8-84.6]) for RoR. None of Clermont score, CRP, or FC predicted QoL. CONCLUSIONS: DWI has inadequate sensitivity and specificity for RoR at 1 year. There is no significant incremental prognostic value of DWI over CRP and FC to predict RoR and/or QoL at 1 year. ADVANCES IN KNOWLEDGE: Early post-induction DWI has no prognostic value for RoR at 1 year.
https://eprints.bournemouth.ac.uk/40753/
Source: PubMed
Diffusion-weighted imaging to predict longer-term response in Crohn's disease patients commencing biological therapy: results from the MOTILITY trial
Authors: Hameed, M., Taylor, S.A., Ahmed, N., Chowdhury, K., Patel, A., Helbren, E., Bhagwanani, A., Hyland, R., Bhatnagar, G., Sidhu, H., Lambie, H., Franklin, J., Mohsin, M., Thomson, E., Boone, D., Tolan, D., Rahman, S., Sakai, N.S., Moran, G.W., Hart, A., Bloom, S., Menys, A., Jacobs, I., Halligan, S., Plumb, A.A., MOTILITY Trial Investigators, T.
Journal: BRITISH JOURNAL OF RADIOLOGY
Publication Date: 11/02/2025
Volume: 98
Issue: 1168
Pages: 527-534
eISSN: 1748-880X
ISSN: 0007-1285
DOI: 10.1093/bjr/tqaf013
https://eprints.bournemouth.ac.uk/40753/
Source: Web of Science
Diffusion-weighted imaging to predict longer-term response in Crohn's disease patients commencing biological therapy: results from the MOTILITY trial.
Authors: Hameed, M., Taylor, S.A., Ahmed, N., Chowdhury, K., Patel, A., Helbren, E., Bhagwanani, A., Hyland, R., Bhatnagar, G., Sidhu, H., Lambie, H., Franklin, J., Mohsin, M., Thomson, E., Boone, D., Tolan, D., Rahman, S., Sakai, N.S., Moran, G.W., Hart, A., Bloom, S., Menys, A., Jacobs, I., Halligan, S., Plumb, A.A., MOTILITY Trial Investigators
Journal: The British journal of radiology
Publication Date: 04/2025
Volume: 98
Issue: 1168
Pages: 527-534
eISSN: 1748-880X
ISSN: 0007-1285
DOI: 10.1093/bjr/tqaf013
Abstract:Objectives
Predicting longer-term response to biological therapy for small bowel Crohn's disease (SBCD) is an unmet clinical need. Diffusion-weighted magnetic resonance (MR) imaging (DWI) may indicate disease activity, but its predictive ability, if any, is unknown. We investigated the prognostic value of DWI for 1 year response or remission (RoR) in SBCD patients commencing biologic therapy, including incremental value over C-reactive protein (CRP) and faecal calprotectin (FC).Methods
A subset of participants in a prospective, multicentre study investigating the predictive ability of motility MRI for 1-year RoR in patients starting biologic therapy for active SBCD, underwent additional DWI at baseline and post-induction (12-30 weeks). CRP and FC were collected in a subgroup. RoR at 1 year was evaluated using clinical and morphological MR enterography (MRE) parameters. We calculated sensitivity and specificity to predict RoR and quality of life (QoL) at 1 year, comparing apparent diffusion coefficient (ADC) value, Clermont score, and CRP using multivariable logistic regression.Results
A total of 25 participants were included (mean 36.9 years, 32% female). ADC changes and Clermont score had poor sensitivity (30.0% [95% CI, 6.7-65.2] and 40.0% [95% CI, 12.2-73.8], respectively) and poor-to-modest specificity (50.0 [95% CI, 27.2-72.8] and 65.0% [95% CI, 40.8-84.6]) for RoR. None of Clermont score, CRP, or FC predicted QoL.Conclusions
DWI has inadequate sensitivity and specificity for RoR at 1 year. There is no significant incremental prognostic value of DWI over CRP and FC to predict RoR and/or QoL at 1 year.Advances in knowledge
Early post-induction DWI has no prognostic value for RoR at 1 year.https://eprints.bournemouth.ac.uk/40753/
Source: Europe PubMed Central