News | May 02, 2013

Inflammatory Bowel Disease Detection Enhanced With PET/CT

May 2, 2013 — Inflammatory bowel diseases (IBD), such as Crohn's disease and ulcerative colitis, may be detected and monitored more effectively in the future with positron emission tomography/computed tomography (PET/CT), according to research published in the May issue of The Journal of Nuclear Medicine. Typically assessed by endoscopic and histologic evaluations, investigators demonstrated the ability of PET/CT to identify lesions along the complete intestinal wall that could be missed with traditional imaging techniques.

"Animal models of intestinal inflammation have contributed substantially to the current understanding of IBD; however, endoscopic examinations on the animals can be complicated, and full histological workup of the murine colon does not allow for serial assessment," said Dominik Bettenworth, M.D., lead author of the study "Translational 18F-FDG PET/CT Imaging to Monitor Lesion Activity in Intestinal Inflammation." "In this study, we evaluated 18F-FDG PET/CT as a noninvasive approach to serially assess IBD activity in small animals and confirmed its utility by analyzing PET/CT scans conducted in patients with Crohn's disease."

For the first phase of the study, researchers induced dextran sodium sulfate (DSS) colitis in mice and assessed the 18F-FDG uptake in multiple sections of the colon. Compared with control mice, an increase in 18F-FDG uptake was clearly noted in the DSS mice, with the most intensive areas of uptake in the medial and distal colon. Significant correlation was found between the PET/CT and histologic evaluations. The experiment also identified extraintestinal alterations, such as bone marrow activation, in the DSS colitis-induced mice.

Based on the results of the experiments in the colitic mice, researchers identified the extent of the mucosal damage as the parameter that correlated best to 18F-FDG uptake in the mice and in human patients with Crohn's disease. 18F-FDG PET/CT scans of 25 Crohn's patients were retrospectively analyzed, and the findings were then correlated to endoscopic procedures performed before or after the CT without any interfering treatments. In accordance with the results in the DSS colitis, an increased 18F-FDG uptake was found in 87 percent of deep mucosal ulcerations, whereas mild endoscopic lesions were detected in approximately 50 percent of patients assessed.

"In Crohn's disease patients, 18F-FDG PET/CT seems to accurately detect advanced inflammatory changes and also unmask subepithelial disease activity that might be missed by colonoscopy. Therefore, PET/CT might serve as an additional tool for evaluating disease activity in IBD patients, e.g., in defining complete remission," noted Bettenworth.

Michael Schäfers, M.D., senior author of the study, added, "Using a clinically established tracer, the translation of this approach into daily clinical routine should benefit patients in the near future and will further promote the use of PET/CT for new indications in clinical algorithms."

Crohn's disease and ulcerative colitis are chronic-remittent, inflammatory conditions featuring characteristic mucosal lesions within the bowel leading to diarrhea, stricture formation, abdominal pain and weight loss. Crohn's disease may affect as many as 700,000 Americans, and ulcerative colitis may affect up to an additional 700,000; incidence rates for these diseases are on the rise worldwide.

Authors of the article "Translational 18F-FDG PET/CT Imaging to Monitor Lesion Activity in Intestinal Inflammation" include Dominik Bettenworth, Tobias Max Nowacki, Matthias Ross, Frank Lenze, Jan Heidemann and Andreas Lügering, Department of Medicine B, University of Münster, Münster, Germany; Stefan Reuter and Bayram Edemir, Department of Medicine D, University of Münster, Münster, Germany; Sven Hermann, European Institute for Molecular Imaging, University of Münster, Münster, Germany, and Department of Nuclear Medicine, University of Münster, Münster, Germany; Matthias Weckesser and Michael Schäfers, Department of Nuclear Medicine, University of Münster, Münster, Germany; Linda Kerstiens and Steffen Koschmieder, Department of Medicine A, University of Münster, Münster, Germany; Athanasios Stratis and Thomas Pap, Institute for Experimental Musculoskeletal Medicine, University of Münster, Münster, Germany; and Christian Maaser, University Teaching Hospital Lüneburg, Lüneburg, Germany.

For more information: jnm.snmjournals.org

 

Related Content

Youth Football Changes Nerve Fibers in Brain

Statistically significant clusters (red-colored) showing group differences (Control vs. Football) in white matter strain along the primary (F1) and secondary (F2) fibers. While body of corpus callosum (BBC) showed relative shrinkage in Football group, the other clusters showed relative stretching of fibers. PCR: Posterior Corona Radiata, PLIC: Posterior Limb of Internal Capsule, SCR: Superior Corona Radiata, SLF: Superior Longitudinal Fasciculus, SCC: Splenium of Corpus Callosum. Image courtesy of Kim et al.

News | Neuro Imaging | December 07, 2018
Magnetic resonance imaging (MRI) scans show repetitive blows to the head result in brain changes among youth football...
Spectrum Dynamics Sues GE for Theft, Misappropriation of Trade Secrets and Unfair Competition
News | SPECT Imaging | December 06, 2018
Single-photon emission computed tomography (SPECT) cardiac imaging company Spectrum Dynamics filed a lawsuit Dec. 6,...
Subtle Medical Receives FDA Clearance, CE Mark for SubtlePET
Technology | PET Imaging | December 05, 2018
Subtle Medical announced 510(k) clearance from the U.S. Food and Drug Administration (FDA) to market SubtlePET. Subtle...
Mirada Medical Joins U.K. Consortium Exploring Healthcare AI
News | Artificial Intelligence | December 04, 2018
Mirada Medical, a leading global brand in medical imaging software, will form part of an artificial intelligence (AI)...
Snoring Poses Greater Cardiac Risk to Women
News | Women's Health | November 29, 2018
Obstructive sleep apnea (OSA) and snoring may lead to earlier impairment of cardiac function in women than in men,...
Artificial Intelligence May Help Reduce Gadolinium Dose in MRI

Example of full-dose, 10 percent low-dose and algorithm-enhanced low-dose. Image courtesy of Enhao Gong, Ph.D.

News | Contrast Media | November 27, 2018
Researchers are using artificial intelligence (AI) to reduce the dose of a contrast agent that may be left behind in...
Women Benefit From Mammography Screening Beyond Age 75
News | Mammography | November 26, 2018
Women age 75 years and older should continue to get screening mammograms because of the comparatively high incidence of...
Siemens Healthineers Showcases syngo Virtual Cockpit for More Flexible Workforce Management
News | Teleradiology | November 25, 2018
During the 104th Scientific Assembly and Annual Meeting of the Radiological Society of North America (RSNA), Nov. 25-30...
Philips Launches IntelliSpace Discovery Research Platform at RSNA
Technology | Artificial Intelligence | November 20, 2018
Ahead of the 2018 Radiological Society of North America Annual Meeting (RSNA), Nov. 25-30 in Chicago, Royal Philips...
Bay Labs and Northwestern Medicine Enroll First Patient in AI Echocardiography Study
News | Cardiovascular Ultrasound | November 19, 2018
Medical artificial intelligence (AI) company Bay Labs and Northwestern Medicine announced that the first patient has...