Changes in dynamic contrast-enhanced pharmacokinetic and diffusion-weighted imaging parameters reflect response to anti-TNF therapy in Crohn's disease

• DOI: 10.1259/bjr.20150547
• Publication Date: 2015-09-24T15:41:38Z
• Authors: Gauraang Bhatnagar; Nikolaos Dikaios; Davide Prezzi; Roser Vega; Steve Halligan; Stuart A Taylor
• Keywords: Interquartile range; Dynamic contrast

To investigate the effect of tumour necrosis factor (TNF)-α antagonists on MRI dynamic contrast-enhanced (DCE) and diffusion-weighted imaging (DWI) parameters in Crohn's disease (CD).42 patients with CD (median age 24 years; 22 females) commencing anti-TNF-α therapy baseline follow-up 51 weeks) 1.5-T MR enterography (MRE) were retrospectively identified. MRE included DCE (n = 20) and/or multi-b-value DWI 17). Slope enhancement (SoE), maximum (ME), area under time-intensity curve (AUC), Ktrans (transfer constant), ve (fractional volume extravascular-extracellular space), apparent diffusion coefficient (ADC) ADCfast/slow derived from most inflamed bowel segments. A physician global assessment activity (remission, mild, moderate severe) at time was assigned, cohort divided into responders non-responders. Data compared using Mann-Whitney U test analysis variance.Follow-up Ktrans, ME, SoE, AUC ADCME changed significantly clinical but not non-responders, {[median [interquartile range (IQR)]: 0.42 (0.38), 1.24 (0.52), 0.18 (0.17), 17.68 (4.70) 1.56 mm(2) s(-1) (0.39 s(-1)) vs [median (IQR): 0.15 (0.22), 0.50 (0.54), 0.07 (0.1), 14.73 (2.06) 2.14 (0.62 s(-1)), for responders, respectively, p 0.006 to 0.037}. SoE higher ME lower remission than those severe [mean (standard deviation): 0.55 (0.46), 0.49 (0.28), 14.32 (1.32)] [0.32 (0.37), 2.21 (2.43) 23.05 (13.66), respectively 0.017 0.033]. ADC [2.34 (0.67 s(-1))] [1.59 (0.26 (p 0.005) [1.63 (0.21 0.038).DCE change TNF-α are different according clinically defined status.DCE CD, suggesting an wall vascularity.