Ding H, Fang YY, Fan WJ, Zhang CY, Wang SF, Hu J, Han W, Mei Q. Computed tomography enterography-based radiomics for assessing mucosal healing in patients with small bowel Crohn's disease. World J Gastroenterol 2025; 31(3): 102283 [DOI: 10.3748/wjg.v31.i3.102283]
Corresponding Author of This Article
Qiao Mei, MD, PhD, Professor, Department of Gastroenterology, The First Affiliated Hospital of Anhui Medical University, No. 218 Jixi Road, Hefei 230022, Anhui Province, China. meiqiaomq@aliyun.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Hao Ding, Yuan-Yuan Fang, Chen-Yu Zhang, Jing Hu, Wei Han, Qiao Mei, Department of Gastroenterology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui Province, China
Wen-Jie Fan, Department of Radiation Oncology, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui Province, China
Shao-Fei Wang, Department of Gastroenterology, Suzhou First People's Hospital, Suzhou 234099, Anhui Province, China
Co-first authors: Hao Ding and Yuan-Yuan Fang.
Co-corresponding authors: Wei Han and Qiao Mei.
Author contributions: Mei Q and Han W were responsible for the conception and design of the work; Ding H, Fang YY, Fan WJ, Zhang CY, Wang SF, and Hu J contributed to the acquisition, analysis, and interpretation of data for the work; Ding H and Fang YY wrote the manuscript; Mei Q reviewed and edited the manuscript; all authors participated in the interpretation of the studies and analysis of the data; all authors read and approved the final manuscript.
Supported by Natural Science Foundation of Anhui Medical University, No. 2023xkj130.
Institutional review board statement: The study was conducted in accordance with the 1964 Helsinki declaration and its later amendments and approved by the Clinical Medical Research Ethics Committee of the First Affiliated Hospital of Anhui Medical University (ETIC 5101116).
Informed consent statement: This study retrospectively collected clinical data of patients with small Crohn’s disease, and these data were analyzed anonymously. The informed consent waiver was granted by the Institutional Review Board.
Conflict-of-interest statement: The authors declare that they have no competing interests.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Qiao Mei, MD, PhD, Professor, Department of Gastroenterology, The First Affiliated Hospital of Anhui Medical University, No. 218 Jixi Road, Hefei 230022, Anhui Province, China. meiqiaomq@aliyun.com
Received: October 13, 2024 Revised: November 19, 2024 Accepted: December 3, 2024 Published online: January 21, 2025 Processing time: 67 Days and 11.4 Hours
Abstract
BACKGROUND
Mucosal healing (MH) is the major therapeutic target for Crohn's disease (CD). As the most commonly involved intestinal segment, small bowel (SB) assessment is crucial for CD patients. Yet, it poses a significant challenge due to its limited accessibility through conventional endoscopic methods.
AIM
To establish a noninvasive radiomic model based on computed tomography enterography (CTE) for MH assessment in SBCD patients.
METHODS
Seventy-three patients diagnosed with SBCD were included and divided into a training cohort (n = 55) and a test cohort (n = 18). Radiomic features were obtained from CTE images to establish a radiomic model. Patient demographics were analysed to establish a clinical model. A radiomic-clinical nomogram was constructed by combining significant clinical and radiomic features. The diagnostic efficacy and clinical benefit were evaluated via receiver operating characteristic (ROC) curve analysis and decision curve analysis (DCA), respectively.
RESULTS
Of the 73 patients enrolled, 25 patients achieved MH. The radiomic-clinical nomogram had an area under the ROC curve of 0.961 (95% confidence interval: 0.886-1.000) in the training cohort and 0.958 (0.877-1.000) in the test cohort and provided superior clinical benefit to either the clinical or radiomic models alone, as demonstrated by DCA.
CONCLUSION
These results indicate that the CTE-based radiomic-clinical nomogram is a promising imaging biomarker for MH and serves as a potential noninvasive alternative to enteroscopy for MH assessment in SBCD patients.
Core Tip: Mucosal healing (MH) of small bowel (SB) in Crohn's disease (CD) is difficult to assess due to its limited accessibility through conventional endoscopic methods. Radiomics is a novel tool and has a good performance in disease diagnosis and efficacy evaluation. Here, we developed a computed tomography enterography-based radiomic-clinical nomogram to assess MH for SBCD patients with an area under the receiver operating characteristic curve of 0.961 in the training cohort and 0.958 in the test cohort, highlighting the potential of radiomics as an imaging biomarker and a noninvasive alternative to enteroscopy for MH assessment in SBCD.
