Diagnostic performance of magnetic resonance enterography disease activity indices compared with a histological reference standard for adult terminal ileal Crohn’s disease: experience from the METRIC trial
<p><strong>Background and Aims:</strong> The simplified magnetic resonance enterography [MRE] index of activity [sMARIA], London, and ‘extended’ London, scoring systems are widely used in Crohn’s disease [CD] to assess disease activity, although validation studies have usually been...
| Päätekijät: | , , , , , , , , , , , , , , , |
|---|---|
| Muut tekijät: | |
| Aineistotyyppi: | Journal article |
| Kieli: | English |
| Julkaistu: |
Oxford University Press
2022
|
| Aiheet: |
| _version_ | 1826310761491726336 |
|---|---|
| author | Kumar, S Parry, T Mallett, S Bhatnagar, G Plumb, A Walsh, S Scott, N Tandon, R Chong, H du Parcq, J Martinez, A Moorghen, M Rodriguez-Justo, M Halligan, S Taylor, SA Travis, S |
| author2 | METRIC study investigators |
| author_facet | METRIC study investigators Kumar, S Parry, T Mallett, S Bhatnagar, G Plumb, A Walsh, S Scott, N Tandon, R Chong, H du Parcq, J Martinez, A Moorghen, M Rodriguez-Justo, M Halligan, S Taylor, SA Travis, S |
| author_sort | Kumar, S |
| collection | OXFORD |
| description | <p><strong>Background and Aims:</strong> The simplified magnetic resonance enterography [MRE] index of activity [sMARIA], London, and ‘extended’ London, scoring systems are widely used in Crohn’s disease [CD] to assess disease activity, although validation studies have usually been single-centre, retrospective, and/or used few readers. Here, we evaluated these MRE indices within a prospective, multicentre, multireader, diagnostic accuracy trial.</p>
<p><strong>Methods:</strong> A subset of participants [newly diagnosed or suspected of relapse] recruited to the METRIC trial with available terminal ileal [TI] biopsies was included. Using pre-specified thresholds, the sensitivity and specificity of sMARIA, London, and ‘extended’ London scores for active and severe [sMARIA] TI CD were calculated using different thresholds for the histological activity index [HAI].</p>
<p><strong>Results:</strong> We studied 111 patients [median age 29 years, interquartile range 21-41, 75 newly diagnosed, 36 suspected relapse] from seven centres, of whom 22 had no active TI CD [HAI = 0], 39 mild [HAI = 1], 13 moderate [HAI = 2], and 37 severe CD activity [HAI = 3]. In total, 26 radiologists prospectively scored MRE datasets as per their usual clinical practice. Sensitivity and specificity for active disease [HAI >0] were 83% [95% confidence interval 74% to 90%] and 41% [23% to 61%] for sMARIA, 76% [67% to 84%] and 64% [43% to 80%] for the London score, and 81% [72% to 88%] and 41% [23% to 61%] for the ‘extended’ London score, respectively. The sMARIA had 84% [69-92%] sensitivity and 53% [41-64%] specificity for severe CD.</p>
<p><strong>Conclusions:</strong> When tested at their proposed cut-offs in a real-world setting, sMARIA, London, and ‘extended’ London indices achieve high sensitivity for active TI disease against a histological reference standard, but specificity is low.</p> |
| first_indexed | 2024-03-07T07:58:14Z |
| format | Journal article |
| id | oxford-uuid:ecabf3ea-79db-4f4f-9bf8-ead4d0ff6156 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T07:58:14Z |
| publishDate | 2022 |
| publisher | Oxford University Press |
| record_format | dspace |
| spelling | oxford-uuid:ecabf3ea-79db-4f4f-9bf8-ead4d0ff61562023-08-25T09:13:13ZDiagnostic performance of magnetic resonance enterography disease activity indices compared with a histological reference standard for adult terminal ileal Crohn’s disease: experience from the METRIC trialJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:ecabf3ea-79db-4f4f-9bf8-ead4d0ff6156ImagingEnglishSymplectic ElementsOxford University Press2022Kumar, SParry, TMallett, SBhatnagar, GPlumb, AWalsh, SScott, NTandon, RChong, Hdu Parcq, JMartinez, AMoorghen, MRodriguez-Justo, MHalligan, STaylor, SATravis, SMETRIC study investigators<p><strong>Background and Aims:</strong> The simplified magnetic resonance enterography [MRE] index of activity [sMARIA], London, and ‘extended’ London, scoring systems are widely used in Crohn’s disease [CD] to assess disease activity, although validation studies have usually been single-centre, retrospective, and/or used few readers. Here, we evaluated these MRE indices within a prospective, multicentre, multireader, diagnostic accuracy trial.</p> <p><strong>Methods:</strong> A subset of participants [newly diagnosed or suspected of relapse] recruited to the METRIC trial with available terminal ileal [TI] biopsies was included. Using pre-specified thresholds, the sensitivity and specificity of sMARIA, London, and ‘extended’ London scores for active and severe [sMARIA] TI CD were calculated using different thresholds for the histological activity index [HAI].</p> <p><strong>Results:</strong> We studied 111 patients [median age 29 years, interquartile range 21-41, 75 newly diagnosed, 36 suspected relapse] from seven centres, of whom 22 had no active TI CD [HAI = 0], 39 mild [HAI = 1], 13 moderate [HAI = 2], and 37 severe CD activity [HAI = 3]. In total, 26 radiologists prospectively scored MRE datasets as per their usual clinical practice. Sensitivity and specificity for active disease [HAI >0] were 83% [95% confidence interval 74% to 90%] and 41% [23% to 61%] for sMARIA, 76% [67% to 84%] and 64% [43% to 80%] for the London score, and 81% [72% to 88%] and 41% [23% to 61%] for the ‘extended’ London score, respectively. The sMARIA had 84% [69-92%] sensitivity and 53% [41-64%] specificity for severe CD.</p> <p><strong>Conclusions:</strong> When tested at their proposed cut-offs in a real-world setting, sMARIA, London, and ‘extended’ London indices achieve high sensitivity for active TI disease against a histological reference standard, but specificity is low.</p> |
| spellingShingle | Imaging Kumar, S Parry, T Mallett, S Bhatnagar, G Plumb, A Walsh, S Scott, N Tandon, R Chong, H du Parcq, J Martinez, A Moorghen, M Rodriguez-Justo, M Halligan, S Taylor, SA Travis, S Diagnostic performance of magnetic resonance enterography disease activity indices compared with a histological reference standard for adult terminal ileal Crohn’s disease: experience from the METRIC trial |
| title | Diagnostic performance of magnetic resonance enterography disease activity indices compared with a histological reference standard for adult terminal ileal Crohn’s disease: experience from the METRIC trial |
| title_full | Diagnostic performance of magnetic resonance enterography disease activity indices compared with a histological reference standard for adult terminal ileal Crohn’s disease: experience from the METRIC trial |
| title_fullStr | Diagnostic performance of magnetic resonance enterography disease activity indices compared with a histological reference standard for adult terminal ileal Crohn’s disease: experience from the METRIC trial |
| title_full_unstemmed | Diagnostic performance of magnetic resonance enterography disease activity indices compared with a histological reference standard for adult terminal ileal Crohn’s disease: experience from the METRIC trial |
| title_short | Diagnostic performance of magnetic resonance enterography disease activity indices compared with a histological reference standard for adult terminal ileal Crohn’s disease: experience from the METRIC trial |
| title_sort | diagnostic performance of magnetic resonance enterography disease activity indices compared with a histological reference standard for adult terminal ileal crohn s disease experience from the metric trial |
| topic | Imaging |
| work_keys_str_mv | AT kumars diagnosticperformanceofmagneticresonanceenterographydiseaseactivityindicescomparedwithahistologicalreferencestandardforadultterminalilealcrohnsdiseaseexperiencefromthemetrictrial AT parryt diagnosticperformanceofmagneticresonanceenterographydiseaseactivityindicescomparedwithahistologicalreferencestandardforadultterminalilealcrohnsdiseaseexperiencefromthemetrictrial AT malletts diagnosticperformanceofmagneticresonanceenterographydiseaseactivityindicescomparedwithahistologicalreferencestandardforadultterminalilealcrohnsdiseaseexperiencefromthemetrictrial AT bhatnagarg diagnosticperformanceofmagneticresonanceenterographydiseaseactivityindicescomparedwithahistologicalreferencestandardforadultterminalilealcrohnsdiseaseexperiencefromthemetrictrial AT plumba diagnosticperformanceofmagneticresonanceenterographydiseaseactivityindicescomparedwithahistologicalreferencestandardforadultterminalilealcrohnsdiseaseexperiencefromthemetrictrial AT walshs diagnosticperformanceofmagneticresonanceenterographydiseaseactivityindicescomparedwithahistologicalreferencestandardforadultterminalilealcrohnsdiseaseexperiencefromthemetrictrial AT scottn diagnosticperformanceofmagneticresonanceenterographydiseaseactivityindicescomparedwithahistologicalreferencestandardforadultterminalilealcrohnsdiseaseexperiencefromthemetrictrial AT tandonr diagnosticperformanceofmagneticresonanceenterographydiseaseactivityindicescomparedwithahistologicalreferencestandardforadultterminalilealcrohnsdiseaseexperiencefromthemetrictrial AT chongh diagnosticperformanceofmagneticresonanceenterographydiseaseactivityindicescomparedwithahistologicalreferencestandardforadultterminalilealcrohnsdiseaseexperiencefromthemetrictrial AT duparcqj diagnosticperformanceofmagneticresonanceenterographydiseaseactivityindicescomparedwithahistologicalreferencestandardforadultterminalilealcrohnsdiseaseexperiencefromthemetrictrial AT martineza diagnosticperformanceofmagneticresonanceenterographydiseaseactivityindicescomparedwithahistologicalreferencestandardforadultterminalilealcrohnsdiseaseexperiencefromthemetrictrial AT moorghenm diagnosticperformanceofmagneticresonanceenterographydiseaseactivityindicescomparedwithahistologicalreferencestandardforadultterminalilealcrohnsdiseaseexperiencefromthemetrictrial AT rodriguezjustom diagnosticperformanceofmagneticresonanceenterographydiseaseactivityindicescomparedwithahistologicalreferencestandardforadultterminalilealcrohnsdiseaseexperiencefromthemetrictrial AT halligans diagnosticperformanceofmagneticresonanceenterographydiseaseactivityindicescomparedwithahistologicalreferencestandardforadultterminalilealcrohnsdiseaseexperiencefromthemetrictrial AT taylorsa diagnosticperformanceofmagneticresonanceenterographydiseaseactivityindicescomparedwithahistologicalreferencestandardforadultterminalilealcrohnsdiseaseexperiencefromthemetrictrial AT traviss diagnosticperformanceofmagneticresonanceenterographydiseaseactivityindicescomparedwithahistologicalreferencestandardforadultterminalilealcrohnsdiseaseexperiencefromthemetrictrial |