MRI Index Can Predict Postop Recurrence in Crohn Disease

A magnetic resonance imaging (MRI) index has been developed and validated for predicting postoperative recurrence (POR) in Crohn disease (CD).

HealthDay News — A magnetic resonance imaging (MRI) index has been developed and validated for predicting postoperative recurrence (POR) in Crohn disease (CD), according to a study published in the May issue of Clinical Gastroenterology and Hepatology.

Marion Schaefer, from Nancy University Hospital in Paris, and colleagues developed and validated an MRI-based index to predict POR in CD. MRI items with good levels of intra- and inter-rater agreement were identified and selected. The MRI in Crohn’s Disease to Predict Postoperative Recurrence (MONITOR) index was assessed in terms of the area under the receiver operating characteristic curve (AUROC) and accuracy. Two radiologists interpreted 73 MRI datasets.

Seven items (bowel wall thickness, contrast enhancement, T2 signal increase, diffusion-weighted signal increase, edema, ulcers, and the length of the diseased segment) were included in the MONITOR index; all had a weighting of 1, except ulcers, which had a weighting of 2.5. The researchers found that the AUROC was 0.80 for the prediction of endoscopic POR. With sensitivity of 79%, specificity of 55%, a positive predictive value of 68%, and a negative predictive value of 78%, the optimal threshold was a MONITOR index ≥1. The AUROC was 0.85 in bootstrap validation. In the validation cohort, sensitivity was 87%, specificity was 75%, the positive predictive value was 84.6%, and the negative predictive value was 75% with a MONITOR index ≥1.

“We have developed and validated a simple, easy-to-use, reliable MRI index for predicting endoscopic POR in CD with high sensitivity and a high negative predictive value,” the authors write.

Several authors disclosed financial ties to the biopharmaceutical and nutrition industries.

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