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Grading of Crohn's disease activity using CT, MRI, US and scintigraphy: a meta-analysis.

Puylaert CA, Tielbeek JA, Bipat S, Stoker J - Eur Radiol (2015)

Bottom Line: Three-by-three tables (none, mild, frank disease) were constructed for all studies, and estimates of accurate, over- and under-grading were calculated/summarized by fixed or random effects models.MRI and US showed grading accuracies of 67-82% and 56-75%, respectively.CT and MRI showed comparable high accurate grading estimates in the per-patient analysis.

View Article: PubMed Central - PubMed

Affiliation: Academic Medical Center, Department of Radiology, University of Amsterdam, Meibergdreef 9, Amsterdam, 1105AZ, The Netherlands. c.a.puylaert@amc.uva.nl.

ABSTRACT

Purpose: To assess the grading of Crohn's disease activity using CT, MRI, US and scintigraphy.

Materials and methods: MEDLINE, EMBASE and Cochrane databases were searched (January 1983-March 2014) for studies evaluating CT, MRI, US and scintigraphy in grading Crohn's disease activity compared to endoscopy, biopsies or intraoperative findings. Two independent reviewers assessed the data. Three-by-three tables (none, mild, frank disease) were constructed for all studies, and estimates of accurate, over- and under-grading were calculated/summarized by fixed or random effects models.

Results: Our search yielded 9356 articles, 19 of which were included. Per-patient data showed accurate grading values for CT, MRI, US and scintigraphy of 86% (95% CI: 75-93%), 84% (95% CI: 67-93%), 44% (95% CI: 28-61%) and 40% (95% CI: 16-70%), respectively. In the per-patient analysis, CT and MRI showed similar accurate grading estimates (P = 0.8). Per-segment data showed accurate grading values for CT and scintigraphy of 87% (95% CI: 77-93%) and 86% (95% CI: 80-91%), respectively. MRI and US showed grading accuracies of 67-82% and 56-75%, respectively.

Conclusions: CT and MRI showed comparable high accurate grading estimates in the per-patient analysis. Results for US and scintigraphy were inconsistent, and limited data were available.

Key points: • CT and MRI have comparable high accuracy in grading Crohn's disease. • Data on US and scintigraphy is inconsistent and limited. • MRI is preferable over CT as it lacks ionizing radiation exposure.

No MeSH data available.


Related in: MedlinePlus

QUADAS signalling questions (Table 1) per domain (from up to down: patient selection, index test, reference test and patient flow). The last column shows whether studies included patients prospectively.
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Fig2: QUADAS signalling questions (Table 1) per domain (from up to down: patient selection, index test, reference test and patient flow). The last column shows whether studies included patients prospectively.

Mentions: Evaluation of the imaging tests was performed blinded from the reference test in 13 studies [17, 18, 21, 22, 24–30, 33, 34]. The reference test was performed blinded to the imaging results in 12 studies [16, 17, 19, 21, 24, 26–30, 33, 34]. The remaining studies did not specify whether observers were blinded to other results [20, 23, 31, 32]. Fifteen of the studies included patients prospectively [16–26, 28, 30, 31, 34]. Signalling questions for the QUADAS tool were answered with ‘yes’ in 78.9 % of cases (Fig. 2). Patient selection and index test domains showed less risk of bias than reference test and patient flow domains. Concern about applicability of patient selection and index and reference tests was generally low (Fig. 3).Fig. 2


Grading of Crohn's disease activity using CT, MRI, US and scintigraphy: a meta-analysis.

Puylaert CA, Tielbeek JA, Bipat S, Stoker J - Eur Radiol (2015)

QUADAS signalling questions (Table 1) per domain (from up to down: patient selection, index test, reference test and patient flow). The last column shows whether studies included patients prospectively.
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4595539&req=5

Fig2: QUADAS signalling questions (Table 1) per domain (from up to down: patient selection, index test, reference test and patient flow). The last column shows whether studies included patients prospectively.
Mentions: Evaluation of the imaging tests was performed blinded from the reference test in 13 studies [17, 18, 21, 22, 24–30, 33, 34]. The reference test was performed blinded to the imaging results in 12 studies [16, 17, 19, 21, 24, 26–30, 33, 34]. The remaining studies did not specify whether observers were blinded to other results [20, 23, 31, 32]. Fifteen of the studies included patients prospectively [16–26, 28, 30, 31, 34]. Signalling questions for the QUADAS tool were answered with ‘yes’ in 78.9 % of cases (Fig. 2). Patient selection and index test domains showed less risk of bias than reference test and patient flow domains. Concern about applicability of patient selection and index and reference tests was generally low (Fig. 3).Fig. 2

Bottom Line: Three-by-three tables (none, mild, frank disease) were constructed for all studies, and estimates of accurate, over- and under-grading were calculated/summarized by fixed or random effects models.MRI and US showed grading accuracies of 67-82% and 56-75%, respectively.CT and MRI showed comparable high accurate grading estimates in the per-patient analysis.

View Article: PubMed Central - PubMed

Affiliation: Academic Medical Center, Department of Radiology, University of Amsterdam, Meibergdreef 9, Amsterdam, 1105AZ, The Netherlands. c.a.puylaert@amc.uva.nl.

ABSTRACT

Purpose: To assess the grading of Crohn's disease activity using CT, MRI, US and scintigraphy.

Materials and methods: MEDLINE, EMBASE and Cochrane databases were searched (January 1983-March 2014) for studies evaluating CT, MRI, US and scintigraphy in grading Crohn's disease activity compared to endoscopy, biopsies or intraoperative findings. Two independent reviewers assessed the data. Three-by-three tables (none, mild, frank disease) were constructed for all studies, and estimates of accurate, over- and under-grading were calculated/summarized by fixed or random effects models.

Results: Our search yielded 9356 articles, 19 of which were included. Per-patient data showed accurate grading values for CT, MRI, US and scintigraphy of 86% (95% CI: 75-93%), 84% (95% CI: 67-93%), 44% (95% CI: 28-61%) and 40% (95% CI: 16-70%), respectively. In the per-patient analysis, CT and MRI showed similar accurate grading estimates (P = 0.8). Per-segment data showed accurate grading values for CT and scintigraphy of 87% (95% CI: 77-93%) and 86% (95% CI: 80-91%), respectively. MRI and US showed grading accuracies of 67-82% and 56-75%, respectively.

Conclusions: CT and MRI showed comparable high accurate grading estimates in the per-patient analysis. Results for US and scintigraphy were inconsistent, and limited data were available.

Key points: • CT and MRI have comparable high accuracy in grading Crohn's disease. • Data on US and scintigraphy is inconsistent and limited. • MRI is preferable over CT as it lacks ionizing radiation exposure.

No MeSH data available.


Related in: MedlinePlus