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<p>Crohn’s disease (CD) is a chronic and relapsing inflammatory disease of the gastrointestinal tract. Diagnostics and follow-up are difficult in small bowel, that can be only partially evaluated by conventional endoscopy. Combined positron emission tomography magnetic resonance enterography (PET-MRE) has shown potential in diagnosing small bowel CD, but its role in monitoring treatment response has not been previously established. This study aimed to evaluate whether PET-MRE can be used to assess the efficacy of medical therapy. We hypothesized that standardized uptake values (SUV) in inflamed small bowel segments would decrease following initiation of standard therapy. A total of 35 volunteer patients with clinically suspected small bowel CD were recruited. All patients underwent ileocolonoscopy and laboratory testing, followed by [<sup>18</sup>F]-FDG PET-MRE. CD diagnosis was confirmed by small bowel capsule endoscopy. Clinicians initiated treatment based on standard diagnostics, blinded to the PET results. Eighteen patients completed follow-up [<sup>18</sup>F]-FDG PET-MRE at three months. Maximum SUV (SUV<sub>Max</sub>) was measured in the small intestine and compared with MRE findings. The median SUV<sub>Max</sub> decreased significantly from baseline to follow-up (3.2 vs. 2.1, <i>p</i> = 0.0025). The Simplified Magnetic Resonance Index of Activity (sMARIA) was also significantly lower at follow-up (<i>p</i> = 0.001). Representatively, median fecal calprotectin declined (451&#xa0;µg/g vs. 163&#xa0;µg/g, <i>p</i> = 0.004). This preliminary prospective study suggests that [<sup>18</sup>F]-FDG PET-MRE may be a useful tool for assessing biochemical response to treatment in newly diagnosed small bowel CD.</p><p>Trial registration number: NCT06796959 (ClinicalTrials.gov). Retrospectively registered on 21.1.2025. Enrollment of first participant on 1.8.2020.</p>

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Combined [18F]-FDG PET-MR imaging for monitoring small bowel crohn’s disease

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年8月26日

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  • Juho Mattila,
  • Johanna Kallio,
  • Eliisa Löyttyniemi,
  • Pirjo Nuutila,
  • Jukka Koffert

摘要

Crohn’s disease (CD) is a chronic and relapsing inflammatory disease of the gastrointestinal tract. Diagnostics and follow-up are difficult in small bowel, that can be only partially evaluated by conventional endoscopy. Combined positron emission tomography magnetic resonance enterography (PET-MRE) has shown potential in diagnosing small bowel CD, but its role in monitoring treatment response has not been previously established. This study aimed to evaluate whether PET-MRE can be used to assess the efficacy of medical therapy. We hypothesized that standardized uptake values (SUV) in inflamed small bowel segments would decrease following initiation of standard therapy. A total of 35 volunteer patients with clinically suspected small bowel CD were recruited. All patients underwent ileocolonoscopy and laboratory testing, followed by [18F]-FDG PET-MRE. CD diagnosis was confirmed by small bowel capsule endoscopy. Clinicians initiated treatment based on standard diagnostics, blinded to the PET results. Eighteen patients completed follow-up [18F]-FDG PET-MRE at three months. Maximum SUV (SUVMax) was measured in the small intestine and compared with MRE findings. The median SUVMax decreased significantly from baseline to follow-up (3.2 vs. 2.1, p = 0.0025). The Simplified Magnetic Resonance Index of Activity (sMARIA) was also significantly lower at follow-up (p = 0.001). Representatively, median fecal calprotectin declined (451 µg/g vs. 163 µg/g, p = 0.004). This preliminary prospective study suggests that [18F]-FDG PET-MRE may be a useful tool for assessing biochemical response to treatment in newly diagnosed small bowel CD.

Trial registration number: NCT06796959 (ClinicalTrials.gov). Retrospectively registered on 21.1.2025. Enrollment of first participant on 1.8.2020.