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- Title
Application of multi-spectral CT imaging in Crohn's disease: a systematic review.
- Authors
Grassi, Giovanni; Laino, Maria Elena; Kalra, Mannudeep; Cherchi, Maria Valeria; Nicola, Refky; Mannelli, Lorenzo; Balestrieri, Antonella; Suri, Jasjit S; Sala, Evis; Saba, Luca
- Abstract
Background: No quantitative computed tomography (CT) biomarker is actually sufficiently accurate to assess Crohn's disease (CD) lesion activity, with adequate precision to guide clinical decisions. Purpose: To assess the available literature on the use of iodine concentration (IC), from multi-spectral CT acquisition, as a quantitative parameter able to distinguish healthy from affected bowel and assess CD bowel activity and heterogeneity of activity along the involved segments. Material and Methods: A literature search was conducted to identify original research studies published up to February 2022. The inclusion criteria were original research papers (>10 human participants), English language publications, focus on dual-energy CT (DECT) of CD with iodine quantification (IQ) as an outcome measure. The exclusion criteria were animal-only studies, languages other than English, review articles, case reports, correspondence, and study populations <10 patients. Results: Nine studies were included in this review; all of which showed a strong correlation between IC measurements and CD activity markers, such as CD activity index (CDAI), endoscopy findings and simple endoscopic score for Crohn's disease (SES-CD), and routine CT enterography (CTE) signs and histopathologic score. Statistically significant differences in IC were reported between affected bowel segments and healthy ones (higher P value was P < 0.001), normal segments and those with active inflammation (P < 0.0001) as well as between patients with active disease and those in remission (P < 0.001). Conclusion: The mean normalized IC at DECTE could be a reliable tool in assisting radiologists in the diagnosis, classification and grading of CD activity.
- Subjects
CROHN'S disease; MULTISPECTRAL imaging; COMPUTED tomography; ISCHEMIC colitis; DISEASE remission; DUAL energy CT (Tomography)
- Publication
Acta Radiologica, 2023, Vol 64, Issue 8, p2347
- ISSN
0284-1851
- Publication type
Article
- DOI
10.1177/02841851231170849