TY - JOUR
T1 - Simple Endoscopic Score of Crohn Disease and Magnetic Resonance Enterography in Children
T2 - Report from ImageKids Study
AU - on behalf of the ImageKids study group. NCT01881490
AU - Weiss, Batia
AU - Turner, Dan
AU - Griffiths, Anne
AU - Walters, Tom
AU - Herman-Sucharska, Izabela
AU - Coppenrath, Eva
AU - Anupindi, Sudha A.
AU - Towbin, Alexander J.
AU - O'Brien, Kathy
AU - Silverstein, Jared
AU - Navas, Victor
AU - Koletzko, Sibylle
AU - Sladek, Malgorzata
AU - Gavish, Matan
AU - Amitai, Michal M.
N1 - Funding Information:
This work has been funded by an educational grant from Abbvie (North Chicago, IL). Abbvie was, however, not involved in any part of the study, including its design, conduct monitoring, analysis, and writing the manuscript.
Publisher Copyright:
Copyright © 2019 ESPGHAN and NASPGHAN. All rights reserved.
PY - 2019/10/1
Y1 - 2019/10/1
N2 - Objectives: We aimed to explore the ability of magnetic resonance enterography (MRE) to impute the simple endoscopic score of Crohn disease (SES-CD) in children with CD, in whom failure of ileal intubation is common and may impair SES-CD calculation in clinical studies. Methods: This is a substudy of the prospective ImageKids study in which children with CD underwent ileocolonoscopy (scored by SES-CD) and MRE (scored on a 100 mm visual analogue scale [VAS] and by MaRIA). Mucosal healing (MH) was defined as SES-CD <3, MRE-VAS <20 mm, and/or MaRIA <7. Results: A total of 237 children (22 centers, age 11.5 ± 3.3 years), were enrolled. Ileal intubation has failed in 40 of 237 (17%). The agreement between SES-CD and MRE was 75% (k = 0.508, P < 0.001) in the ileum, and 68% to 85% in the colonic segments (k = 0.21-0.50, P < 0.001). The sensitivity and specificity of ileal MRE-VAS for MH were 91.7% (95% confidence interval 0.84-0.96) and 53.1% (95% confidence interval 0.43-0.63), respectively. The ileal MaRIA score (calculated in 33/40) was higher in the children without ileal intubation than in the others (20.5 ± 7.1 vs 15.1 ± 10.8, respectively, P = 0.0018). In 7% (16/237) of children, isolated active ileal disease would have been missed when considering SES-CD only. A multivariable model predicted the ileal SES-CD subscore from the MaRIA: SES-CDileum = 1.145 + 0.169 × MaRIAileum rounded to the nearest whole number (R2 = 0.17). Applying this model to the children without ileal intubation revealed that 29 of 33 (88%) had ileal disease; 8 of 29 patients (28%) with normal colonic SES-CD had imputed ileal SES-CD ≥3. Conclusions: MRE is useful for imputing the ileal disease in pediatric clinical studies, overcoming the problem of ileal nonintubation.
AB - Objectives: We aimed to explore the ability of magnetic resonance enterography (MRE) to impute the simple endoscopic score of Crohn disease (SES-CD) in children with CD, in whom failure of ileal intubation is common and may impair SES-CD calculation in clinical studies. Methods: This is a substudy of the prospective ImageKids study in which children with CD underwent ileocolonoscopy (scored by SES-CD) and MRE (scored on a 100 mm visual analogue scale [VAS] and by MaRIA). Mucosal healing (MH) was defined as SES-CD <3, MRE-VAS <20 mm, and/or MaRIA <7. Results: A total of 237 children (22 centers, age 11.5 ± 3.3 years), were enrolled. Ileal intubation has failed in 40 of 237 (17%). The agreement between SES-CD and MRE was 75% (k = 0.508, P < 0.001) in the ileum, and 68% to 85% in the colonic segments (k = 0.21-0.50, P < 0.001). The sensitivity and specificity of ileal MRE-VAS for MH were 91.7% (95% confidence interval 0.84-0.96) and 53.1% (95% confidence interval 0.43-0.63), respectively. The ileal MaRIA score (calculated in 33/40) was higher in the children without ileal intubation than in the others (20.5 ± 7.1 vs 15.1 ± 10.8, respectively, P = 0.0018). In 7% (16/237) of children, isolated active ileal disease would have been missed when considering SES-CD only. A multivariable model predicted the ileal SES-CD subscore from the MaRIA: SES-CDileum = 1.145 + 0.169 × MaRIAileum rounded to the nearest whole number (R2 = 0.17). Applying this model to the children without ileal intubation revealed that 29 of 33 (88%) had ileal disease; 8 of 29 patients (28%) with normal colonic SES-CD had imputed ileal SES-CD ≥3. Conclusions: MRE is useful for imputing the ileal disease in pediatric clinical studies, overcoming the problem of ileal nonintubation.
KW - Crohn disease
KW - MaRIA
KW - children
KW - magnetic resonance enterography
KW - simple endoscopic score of Crohn disease
UR - http://www.scopus.com/inward/record.url?scp=85072166794&partnerID=8YFLogxK
U2 - 10.1097/MPG.0000000000002404
DO - 10.1097/MPG.0000000000002404
M3 - Article
C2 - 31136561
AN - SCOPUS:85072166794
SN - 0277-2116
VL - 69
SP - 461
EP - 465
JO - Journal of Pediatric Gastroenterology and Nutrition
JF - Journal of Pediatric Gastroenterology and Nutrition
IS - 4
ER -