In:
Journal of Crohn's and Colitis, Oxford University Press (OUP), Vol. 16, No. 10 ( 2022-11-01), p. 1531-1539
Abstract:
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. Methods 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] . Results 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 & gt;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. Conclusions 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.
Type of Medium:
Online Resource
ISSN:
1873-9946
,
1876-4479
DOI:
10.1093/ecco-jcc/jjac062
Language:
English
Publisher:
Oxford University Press (OUP)
Publication Date:
2022
detail.hit.zdb_id:
2389631-0
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