title: Non-Invasive Assessment of Inflammation and Treatment Response in Patients with Crohn's Disease and Ulcerative Colitis using Contrast-Enhanced Ultrasonography Quantification.
abstract: OBJECTIVE
  Novel biological therapies in Crohn's disease (CD) or Ulcerative colitis (UC) require a proper follow-up for the assessment of bowel inflammation. While endoscopy is the standard method, the imaging techniques using contrast, particularly contrast enhanced ultrasonography (CEUS), are better tolerated by the patients and can be used more frequently. Our aim was to find the usefulness of dynamic CEUS quantification as compared to endoscopy in the assessment of disease activity and in the follow-up under therapy of the patients suffering from either CD or UC.
  
  
  METHODS
  We have prospectively evaluated 67 patients with UC and 46 with CD, diagnosed by ileo-colonoscopy and biopsy, comparing the endoscopic scores with clinical scores, C reactive protein (CRP), intestinal wall thickness, layer scores after CEUS and TIC parameters (using SonoLiver® software - Imax, RT, TTP, mTT and AUC). For 25 patients with UC and 13 with CD we performed comparisons of the parameters before and after 3 months of treatment and correlated them with the changes in the endoscopic scores.
  
  
  RESULTS
  For UC, time-intensity curves (TIC) volume parameters (AUC) correlated better with endoscopy (ρ=0.64) than the clinical score (ρ =0.62). Other parameters such as CRP and thickness showed significant but less strong correlation, while TIC flow parameters (RT, TTP and mTT) did not show a significant correlation. Results were similar for CD (ρ=0.64 for Imax vs ρ=0.58 for CDAI). The best predictor for endoscopic improvement in both UC and CD was ln(AUC), with a Wilcoxon Z score of 3.76 and 2.61, respectively. There was also a good correlation between the difference of its values and the difference in endoscopic scores before and after the treatment (rho is 0.68 in UC and 0.73 in CD).
authors.affiliation: University of Medicine and Pharmacy Iuliu Hatieganu, and Regional Institute of Gastroenterology and Hepatology Prof. Dr. Octavian Fodor, Cluj-Napoca, Romania. socacium@yahoo.com.
authors.forename: Mihai
authors.initials: M
authors.lastname: Socaciu
authors.affiliation: University of Medicine and Pharmacy Iuliu Hatieganu, and Regional Institute of Gastroenterology and Hepatology Prof. Dr. Octavian Fodor, Cluj-Napoca, Romania.
authors.forename: Lidia
authors.initials: L
authors.lastname: Ciobanu
authors.affiliation: University of Medicine and Pharmacy Iuliu Hatieganu, and Regional Institute of Gastroenterology and Hepatology Prof. Dr. Octavian Fodor, Cluj-Napoca, Romania.
authors.forename: Brindusa
authors.initials: B
authors.lastname: Diaconu
authors.affiliation: University of Medicine and Pharmacy Iuliu Hatieganu, and Regional Institute of Gastroenterology and Hepatology Prof. Dr. Octavian Fodor, Cluj-Napoca, Romania.
authors.forename: Claudia
authors.initials: C
authors.lastname: Hagiu
authors.affiliation: University of Medicine and Pharmacy Iuliu Hatieganu, and Regional Institute of Gastroenterology and Hepatology Prof. Dr. Octavian Fodor, Cluj-Napoca, Romania.
authors.forename: Andrada
authors.initials: A
authors.lastname: Seicean
authors.affiliation: University of Medicine and Pharmacy Iuliu Hatieganu, and Regional Institute of Gastroenterology and Hepatology Prof. Dr. Octavian Fodor, Cluj-Napoca, Romania.
authors.forename: Radu
authors.initials: R
authors.lastname: Badea
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D019540:Area Under Curve; D001688:Biological Products / Q000627:therapeutic use; D001706:Biopsy; D003093:Colitis, Ulcerative / Q000000981:diagnostic imaging* / Q000188:drug therapy; D003106:Colon / Q000000981:diagnostic imaging* / Q000187:drug effects / Q000473:pathology; D003113:Colonoscopy; D003287:Contrast Media / Q000008:administration & dosage*; D003424:Crohn Disease / Q000000981:diagnostic imaging* / Q000188:drug therapy; D005260:Female; D005765:Gastrointestinal Agents / Q000627:therapeutic use; D006801:Humans; D007082:Ileum / Q000000981:diagnostic imaging* / Q000187:drug effects / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010743:Phospholipids / Q000008:administration & dosage*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D013459:Sulfur Hexafluoride / Q000008:administration & dosage*; D013997:Time Factors; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color; D055815:Young Adult
chemical_list: D000893:Anti-Inflammatory Agents; D001688:Biological Products; D003287:Contrast Media; D005765:Gastrointestinal Agents; D010743:Phospholipids; C420843:contrast agent BR1; D013459:Sulfur Hexafluoride