Development and validation of multiparametric models based on computed tomography enterography to determine endoscopic activity and surgical risk in patients with Crohn's disease: A multi-center study
Objective: To develop novel multiparametric models based on computed tomography enterography (CTE) scores to identify endoscopic activity and surgical risk in patients with Crohn's disease (CD). Methods: We analyzed 171 patients from 3 hospitals. Correlations between CTE outcomes and endoscopic...
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Format: | Article |
Language: | English |
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Elsevier
2023-09-01
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Series: | Heliyon |
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Online Access: | http://www.sciencedirect.com/science/article/pii/S2405844023071505 |
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author | Ruiqing Liu Shunli Liu Li Yi Dongsheng Wang Xiaoming Zhou Wang Zhiming Keyu Ren Jia Ke Weiming Zhu Yun Lu |
author_facet | Ruiqing Liu Shunli Liu Li Yi Dongsheng Wang Xiaoming Zhou Wang Zhiming Keyu Ren Jia Ke Weiming Zhu Yun Lu |
author_sort | Ruiqing Liu |
collection | DOAJ |
description | Objective: To develop novel multiparametric models based on computed tomography enterography (CTE) scores to identify endoscopic activity and surgical risk in patients with Crohn's disease (CD). Methods: We analyzed 171 patients from 3 hospitals. Correlations between CTE outcomes and endoscopic scores were assessed using Spearman's rank correlation analysis. Predictive models for moderate to severe CD were developed, and receiver operating characteristic (ROC) curves were constructed to determine the area under the ROC curve (AUC). A combined nomogram based on CTE scores and clinical variables was also developed for predicting moderate to severe CD and surgery. Results: CTE scores were significantly correlated with endoscopy scores at the segment level. The global CTE score was an independent predictor of severe (HR = 1.231, 95% CI: 1.048–1.446, p = 0.012) and moderate-to-severe Simplified Endoscopic Scores for Crohn's Disease (SES-CD) (HR = 1.202, 95% CI: 1.090–1.325, p < 0.001). The nomogram integrating CTE and clinical data predicted moderate to severe SES-CD and severe SES-CD scores in the validation cohort with AUCs of 0.837 and 0.807, respectively. The CTE score (HR = 1.18; 95% CI: 1.103–1.262; p = 0.001) and SES-CD score (HR = 3.125, 95% CI: 1.542–6.33; p = 0.001) were independent prognostic factors for surgery-free survival. A prognostic nomogram incorporating CTE scores, SES-CD and C-reactive protein (CRP) accurately predicted the risk of surgery in patients with CD. Conclusion: The newly developed CTE score and multiparametric models displayed high accuracy in predicting moderate to severe CD and surgical risk for CD patients. |
first_indexed | 2024-03-11T20:50:09Z |
format | Article |
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institution | Directory Open Access Journal |
issn | 2405-8440 |
language | English |
last_indexed | 2024-03-11T20:50:09Z |
publishDate | 2023-09-01 |
publisher | Elsevier |
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series | Heliyon |
spelling | doaj.art-fa09f50c3ce14c97b8c2fe09f274aa552023-10-01T06:01:57ZengElsevierHeliyon2405-84402023-09-0199e19942Development and validation of multiparametric models based on computed tomography enterography to determine endoscopic activity and surgical risk in patients with Crohn's disease: A multi-center studyRuiqing Liu0Shunli Liu1Li Yi2Dongsheng Wang3Xiaoming Zhou4Wang Zhiming5Keyu Ren6Jia Ke7Weiming Zhu8Yun Lu9Department of Gastrointestinal Surgery, The Affiliated Hospital of Qingdao University, 16 Jiangsu Road, Qingdao, Shandong, ChinaDepartment of Radiology, The Affiliated Hospital of Qingdao University Qingdao, 16 Jiangsu Road, Qingdao, Shandong, ChinaDepartment of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, 210002, Jiangsu Province, ChinaDepartment of Gastrointestinal Surgery, The Affiliated Hospital of Qingdao University, 16 Jiangsu Road, Qingdao, Shandong, ChinaDepartment of Radiology, The Affiliated Hospital of Qingdao University Qingdao, 16 Jiangsu Road, Qingdao, Shandong, ChinaDepartment of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, 210002, Jiangsu Province, ChinaDepartment of Gastroenterology, The Affiliated Hospital of Qingdao University, Qingdao, ChinaDepartment of Colorectal Surgery, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510655, Guangdong, ChinaDepartment of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, 210002, Jiangsu Province, ChinaDepartment of Gastrointestinal Surgery, The Affiliated Hospital of Qingdao University, 16 Jiangsu Road, Qingdao, Shandong, China; Corresponding author.Objective: To develop novel multiparametric models based on computed tomography enterography (CTE) scores to identify endoscopic activity and surgical risk in patients with Crohn's disease (CD). Methods: We analyzed 171 patients from 3 hospitals. Correlations between CTE outcomes and endoscopic scores were assessed using Spearman's rank correlation analysis. Predictive models for moderate to severe CD were developed, and receiver operating characteristic (ROC) curves were constructed to determine the area under the ROC curve (AUC). A combined nomogram based on CTE scores and clinical variables was also developed for predicting moderate to severe CD and surgery. Results: CTE scores were significantly correlated with endoscopy scores at the segment level. The global CTE score was an independent predictor of severe (HR = 1.231, 95% CI: 1.048–1.446, p = 0.012) and moderate-to-severe Simplified Endoscopic Scores for Crohn's Disease (SES-CD) (HR = 1.202, 95% CI: 1.090–1.325, p < 0.001). The nomogram integrating CTE and clinical data predicted moderate to severe SES-CD and severe SES-CD scores in the validation cohort with AUCs of 0.837 and 0.807, respectively. The CTE score (HR = 1.18; 95% CI: 1.103–1.262; p = 0.001) and SES-CD score (HR = 3.125, 95% CI: 1.542–6.33; p = 0.001) were independent prognostic factors for surgery-free survival. A prognostic nomogram incorporating CTE scores, SES-CD and C-reactive protein (CRP) accurately predicted the risk of surgery in patients with CD. Conclusion: The newly developed CTE score and multiparametric models displayed high accuracy in predicting moderate to severe CD and surgical risk for CD patients.http://www.sciencedirect.com/science/article/pii/S2405844023071505Computed tomography enterographyEndoscopic activitySurgical riskCrohn's disease |
spellingShingle | Ruiqing Liu Shunli Liu Li Yi Dongsheng Wang Xiaoming Zhou Wang Zhiming Keyu Ren Jia Ke Weiming Zhu Yun Lu Development and validation of multiparametric models based on computed tomography enterography to determine endoscopic activity and surgical risk in patients with Crohn's disease: A multi-center study Heliyon Computed tomography enterography Endoscopic activity Surgical risk Crohn's disease |
title | Development and validation of multiparametric models based on computed tomography enterography to determine endoscopic activity and surgical risk in patients with Crohn's disease: A multi-center study |
title_full | Development and validation of multiparametric models based on computed tomography enterography to determine endoscopic activity and surgical risk in patients with Crohn's disease: A multi-center study |
title_fullStr | Development and validation of multiparametric models based on computed tomography enterography to determine endoscopic activity and surgical risk in patients with Crohn's disease: A multi-center study |
title_full_unstemmed | Development and validation of multiparametric models based on computed tomography enterography to determine endoscopic activity and surgical risk in patients with Crohn's disease: A multi-center study |
title_short | Development and validation of multiparametric models based on computed tomography enterography to determine endoscopic activity and surgical risk in patients with Crohn's disease: A multi-center study |
title_sort | development and validation of multiparametric models based on computed tomography enterography to determine endoscopic activity and surgical risk in patients with crohn s disease a multi center study |
topic | Computed tomography enterography Endoscopic activity Surgical risk Crohn's disease |
url | http://www.sciencedirect.com/science/article/pii/S2405844023071505 |
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