Crohn Disease Prognostication With Semiautomatic Dual-Energy Computed Tomography Enterography-Derived Iodine Density
J Comput Assist Tomogr . 2021 Mar-Apr 01;45(2):171-176. doi: 10.1097/RCT.0000000000001135.
Bari Dane, Ahmad Garada, Thomas O'Donnell, Shannon Chang, Alec Megibow
Objective: The objective of this study was to determine if dual-energy computed tomography enterography (DECTE)-obtained iodine density can predict medical management change or surgery in Crohn disease patients.
Methods: The most active-appearing bowel segment on DECTE in 21 Crohn disease patients was retrospectively interrogated with prototype software determining the percentage of bowel wall (I) in specified ranges. Patients were categorized into 3 groups after DECTE: (1) no management change, (2) outpatient medication change, and (3) inpatient admission or surgery. Crohn's disease activity index was calculated. Group 3's percentage iodine density of >3 mg/mL and Crohn's disease activity index were compared with group 1/2. Crohn's disease activity index and percentage iodine density of >2 mg/mL were compared for groups 2/3 versus group 1 patients.
Results: There were 5 group 1, 6 group 2, and 10 group 3 patients. Group 3 patients had higher frequency of iodine density >3 mg/mL (27%) compared with groups 1/2 patients (12.6%) (P < 0.05). Crohn's disease activity index was similar (P = 0.98). Groups 2/3 patients had 60.5% iodine density of >2 mg/mL, whereas group 1 patients had 31.7% iodine density of >2 mg/mL (P < 0.05). Crohn's disease activity index was similar (P = 0.12).
Conclusions: Iodine density from DECTE may predict medical or surgical Crohn disease management.
Read Full Article Here: https://doi.org/10.1097/rct.0000000000001135