Application of multi-spectral CT imaging in Crohn's disease: a systematic review

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#humans #crohn-disease #tomography-x-ray-computed #intestines #biomarkers

Application of multi-spectral CT imaging in Crohn's disease: a systematic review

Grassi et al., 2023 | Acta Radiol | Systematic Review

Citation

Grassi Giovanni, Laino Maria Elena, ... Saba Luca. Application of multi-spectral CT imaging in Crohn's disease: a systematic review. Acta Radiol. 2023-Aug;64(8):2347-2356. doi:10.1177/02841851231170849

Abstract

BACKGROUND: No quantitative computed tomography (CT) biomarker is actually sufficiently accurate to assess Crohn's disease (CD) lesion activity, with adequate precision to guide clinical decisions. PURPOSE: To assess the available literature on the use of iodine concentration (IC), from multi-spectral CT acquisition, as a quantitative parameter able to distinguish healthy from affected bowel and assess CD bowel activity and heterogeneity of activity along the involved segments. MATERIAL AND METHODS: A literature search was conducted to identify original research studies published up to February 2022. The inclusion criteria were original research papers (>10 human participants), English language publications, focus on dual-energy CT (DECT) of CD with iodine quantification (IQ) as an outcome measure. The exclusion criteria were animal-only studies, languages other than English, review articles, case reports, correspondence, and study populations <10 patients. RESULTS: Nine studies were included in this review; all of which showed a strong correlation between IC measurements and CD activity markers, such as CD activity index (CDAI), endoscopy findings and simple endoscopic score for Crohn's disease (SES-CD), and routine CT enterography (CTE) signs and histopathologic score. Statistically significant differences in IC were reported between affected bowel segments and healthy ones (higher P value was P < 0.001), normal segments and those with active inflammation (P < 0.0001) as well as between patients with active disease and those in remission (P < 0.001). CONCLUSION: The mean normalized IC at DECTE could be a reliable tool in assisting radiologists in the diagnosis, classification and grading of CD activity.

Key Findings

Nine studies were included in this review; all of which showed a strong correlation between IC measurements and CD activity markers, such as CD activity index (CDAI), endoscopy findings and simple endoscopic score for Crohn's disease (SES-CD), and routine CT enterography (CTE) signs and histopathologic score. Statistically significant differences in IC were reported between affected bowel segments and healthy ones (higher P value was P < 0.001), normal segments and those with active inflammation

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population active disease and those
Sample Size 10
Age Range See abstract
Condition inflammation

MeSH Terms

  • Humans
  • Crohn Disease
  • Tomography, X-Ray Computed
  • Intestines
  • Biomarkers
  • Iodine

Evidence Classification

  • Level: Systematic Review
  • Publication Types: Systematic Review, Journal Article
  • Vertical: iodine

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09