Ultrasound elasticity imaging predicts therapeutic outcomes of patients with Crohn's disease treated with anti-tumour necrosis factor antibodies

Stefania Orlando, Mirella Fraquelli, Marina Coletta, Federica Branchi, Andrea Magarotto, Clara Benedetta Conti, Stefano Mazza, Dario Conte, Guido Basilisco, Flavio Caprioli

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Background and Aims: Ultrasound elasticity imaging is a non-invasive technique developed to evaluate fibrosis. Measuring tissue strain by ultrasound elasticity imaging can reliably detect severe ileal fibrosis in patients with Crohn's disease [CD]. We have hypothesised that a more severe range of fibrosis might influence the therapeutic response to anti-tumour necrosis factor [TNF] treatment. The aim of this study was to assess the ability of ultrasound elasticity imaging to predict the therapeutic outcome for CD patients. Methods: Consecutive patients with ileal/ileocolonic CD, starting anti-TNF treatment, were enrolled for the study. These patients underwent bowel ultrasound and ultrasound elasticity imaging at baseline and at 14 and 52 weeks after anti-TNF treatment. Bowel wall stiffness was quantified by calculating the strain ratio between the mesenteric tissue and the bowel wall. Strain ratio ≥ 2 was used to identify severe ileal fibrosis. Transmural healing at 14 and 52 weeks was defined as bowel wall thickness ≤ 3 mm. Results: Thirty patients with CD were enrolled. Five patients underwent surgery for bowel obstruction. The frequency of surgeries was significantly greater in patients with a strain ratio ≥ 2 at baseline [p = 0.003]. A significant reduction of the bowel thickness was observed after 14 and 52 weeks of anti-TNF treatment [p < 0.005]. A significant inverse correlation was observed between the strain ratio values at baseline and the thickness variations following anti-TNF therapy [p = 0.007]; 27% of patients achieved transmural healing at 14 weeks. The baseline strain ratio was significantly lower in patients with transmural healing [p < 0.05]. Conclusions: This study shows that ultrasound elasticity imaging predicts therapeutic outcomes for CD patients treated with anti-TNF.

Original languageEnglish
Pages (from-to)63-70
Number of pages8
JournalJournal of Crohn's and Colitis
Volume12
Issue number1
DOIs
Publication statusPublished - Jan 1 2018

Fingerprint

Elasticity
Crohn Disease
Ultrasonography
Tumor Necrosis Factor-alpha
Antibodies
Fibrosis
Therapeutics

Keywords

  • Crohn's disease
  • Elasticity
  • Elastography
  • Fibrosis
  • Strain
  • Ultrasound

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Ultrasound elasticity imaging predicts therapeutic outcomes of patients with Crohn's disease treated with anti-tumour necrosis factor antibodies. / Orlando, Stefania; Fraquelli, Mirella; Coletta, Marina; Branchi, Federica; Magarotto, Andrea; Conti, Clara Benedetta; Mazza, Stefano; Conte, Dario; Basilisco, Guido; Caprioli, Flavio.

In: Journal of Crohn's and Colitis, Vol. 12, No. 1, 01.01.2018, p. 63-70.

Research output: Contribution to journalArticle

@article{4ab6cad5f4614bbb896efda4bc35a9aa,
title = "Ultrasound elasticity imaging predicts therapeutic outcomes of patients with Crohn's disease treated with anti-tumour necrosis factor antibodies",
abstract = "Background and Aims: Ultrasound elasticity imaging is a non-invasive technique developed to evaluate fibrosis. Measuring tissue strain by ultrasound elasticity imaging can reliably detect severe ileal fibrosis in patients with Crohn's disease [CD]. We have hypothesised that a more severe range of fibrosis might influence the therapeutic response to anti-tumour necrosis factor [TNF] treatment. The aim of this study was to assess the ability of ultrasound elasticity imaging to predict the therapeutic outcome for CD patients. Methods: Consecutive patients with ileal/ileocolonic CD, starting anti-TNF treatment, were enrolled for the study. These patients underwent bowel ultrasound and ultrasound elasticity imaging at baseline and at 14 and 52 weeks after anti-TNF treatment. Bowel wall stiffness was quantified by calculating the strain ratio between the mesenteric tissue and the bowel wall. Strain ratio ≥ 2 was used to identify severe ileal fibrosis. Transmural healing at 14 and 52 weeks was defined as bowel wall thickness ≤ 3 mm. Results: Thirty patients with CD were enrolled. Five patients underwent surgery for bowel obstruction. The frequency of surgeries was significantly greater in patients with a strain ratio ≥ 2 at baseline [p = 0.003]. A significant reduction of the bowel thickness was observed after 14 and 52 weeks of anti-TNF treatment [p < 0.005]. A significant inverse correlation was observed between the strain ratio values at baseline and the thickness variations following anti-TNF therapy [p = 0.007]; 27{\%} of patients achieved transmural healing at 14 weeks. The baseline strain ratio was significantly lower in patients with transmural healing [p < 0.05]. Conclusions: This study shows that ultrasound elasticity imaging predicts therapeutic outcomes for CD patients treated with anti-TNF.",
keywords = "Crohn's disease, Elasticity, Elastography, Fibrosis, Strain, Ultrasound",
author = "Stefania Orlando and Mirella Fraquelli and Marina Coletta and Federica Branchi and Andrea Magarotto and Conti, {Clara Benedetta} and Stefano Mazza and Dario Conte and Guido Basilisco and Flavio Caprioli",
year = "2018",
month = "1",
day = "1",
doi = "10.1093/ecco-jcc/jjx116",
language = "English",
volume = "12",
pages = "63--70",
journal = "Journal of Crohn's and Colitis",
issn = "1873-9946",
publisher = "Oxford University Press",
number = "1",

}

TY - JOUR

T1 - Ultrasound elasticity imaging predicts therapeutic outcomes of patients with Crohn's disease treated with anti-tumour necrosis factor antibodies

AU - Orlando, Stefania

AU - Fraquelli, Mirella

AU - Coletta, Marina

AU - Branchi, Federica

AU - Magarotto, Andrea

AU - Conti, Clara Benedetta

AU - Mazza, Stefano

AU - Conte, Dario

AU - Basilisco, Guido

AU - Caprioli, Flavio

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background and Aims: Ultrasound elasticity imaging is a non-invasive technique developed to evaluate fibrosis. Measuring tissue strain by ultrasound elasticity imaging can reliably detect severe ileal fibrosis in patients with Crohn's disease [CD]. We have hypothesised that a more severe range of fibrosis might influence the therapeutic response to anti-tumour necrosis factor [TNF] treatment. The aim of this study was to assess the ability of ultrasound elasticity imaging to predict the therapeutic outcome for CD patients. Methods: Consecutive patients with ileal/ileocolonic CD, starting anti-TNF treatment, were enrolled for the study. These patients underwent bowel ultrasound and ultrasound elasticity imaging at baseline and at 14 and 52 weeks after anti-TNF treatment. Bowel wall stiffness was quantified by calculating the strain ratio between the mesenteric tissue and the bowel wall. Strain ratio ≥ 2 was used to identify severe ileal fibrosis. Transmural healing at 14 and 52 weeks was defined as bowel wall thickness ≤ 3 mm. Results: Thirty patients with CD were enrolled. Five patients underwent surgery for bowel obstruction. The frequency of surgeries was significantly greater in patients with a strain ratio ≥ 2 at baseline [p = 0.003]. A significant reduction of the bowel thickness was observed after 14 and 52 weeks of anti-TNF treatment [p < 0.005]. A significant inverse correlation was observed between the strain ratio values at baseline and the thickness variations following anti-TNF therapy [p = 0.007]; 27% of patients achieved transmural healing at 14 weeks. The baseline strain ratio was significantly lower in patients with transmural healing [p < 0.05]. Conclusions: This study shows that ultrasound elasticity imaging predicts therapeutic outcomes for CD patients treated with anti-TNF.

AB - Background and Aims: Ultrasound elasticity imaging is a non-invasive technique developed to evaluate fibrosis. Measuring tissue strain by ultrasound elasticity imaging can reliably detect severe ileal fibrosis in patients with Crohn's disease [CD]. We have hypothesised that a more severe range of fibrosis might influence the therapeutic response to anti-tumour necrosis factor [TNF] treatment. The aim of this study was to assess the ability of ultrasound elasticity imaging to predict the therapeutic outcome for CD patients. Methods: Consecutive patients with ileal/ileocolonic CD, starting anti-TNF treatment, were enrolled for the study. These patients underwent bowel ultrasound and ultrasound elasticity imaging at baseline and at 14 and 52 weeks after anti-TNF treatment. Bowel wall stiffness was quantified by calculating the strain ratio between the mesenteric tissue and the bowel wall. Strain ratio ≥ 2 was used to identify severe ileal fibrosis. Transmural healing at 14 and 52 weeks was defined as bowel wall thickness ≤ 3 mm. Results: Thirty patients with CD were enrolled. Five patients underwent surgery for bowel obstruction. The frequency of surgeries was significantly greater in patients with a strain ratio ≥ 2 at baseline [p = 0.003]. A significant reduction of the bowel thickness was observed after 14 and 52 weeks of anti-TNF treatment [p < 0.005]. A significant inverse correlation was observed between the strain ratio values at baseline and the thickness variations following anti-TNF therapy [p = 0.007]; 27% of patients achieved transmural healing at 14 weeks. The baseline strain ratio was significantly lower in patients with transmural healing [p < 0.05]. Conclusions: This study shows that ultrasound elasticity imaging predicts therapeutic outcomes for CD patients treated with anti-TNF.

KW - Crohn's disease

KW - Elasticity

KW - Elastography

KW - Fibrosis

KW - Strain

KW - Ultrasound

UR - http://www.scopus.com/inward/record.url?scp=85040549774&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85040549774&partnerID=8YFLogxK

U2 - 10.1093/ecco-jcc/jjx116

DO - 10.1093/ecco-jcc/jjx116

M3 - Article

AN - SCOPUS:85040549774

VL - 12

SP - 63

EP - 70

JO - Journal of Crohn's and Colitis

JF - Journal of Crohn's and Colitis

SN - 1873-9946

IS - 1

ER -