The value of combined positron emission tomography/magnetic resonance imaging to diagnose inflammatory bowel disease: a prospective study

Acta Radiol. 2021 Jul;62(7):851-857. doi: 10.1177/0284185120944900. Epub 2020 Jul 28.

Abstract

Background: The clinical utility of positron emission tomography/magnetic resonance imaging (PET/MRI) in comparison to standard work-up with patients with known or suspected inflammatory bowel disease (IBD) is unknown.

Purpose: To evaluate the value of 18F-fluorodeoxyglucose (18F-FDG) PET/MRI in the diagnostics of IBD and further compare the data obtained using PET/MRI to histological findings.

Materials and methods: Ten patients with relapse in IBD or with symptoms of suspected IBD were recruited either from a gastroenterology outpatient clinic or from a hospital ward. Intestinal inflammation was assessed with histology and 18F-FDG PET/MRI. Maximum standard uptake values (SUVmax) were calculated in six regions of the intestine (small bowel, ascending, transverse, descending and sigmoid colon, and rectum) and compared to histological analysis of inflammation activity.

Results: The study showed that both the inflammation activity (P = 0.008) and the region of the biopsy in the intestine (P = 0.015) had a significant effect on SUV. SUVs obtained from severe inflammation activity emerged significantly from the background (P = 0.006). In addition, the SUVs obtained from moderate inflammation raised from background, but the difference was not statistically significant (P = 0.083), while SUVs of mild inflammation were at the same level with SUVs of normal bowel wall (P = 0.988).

Conclusion: 18F-FDG PET/MRI is a promising method of detecting especially severe inflammatory bowel lesions. More data are required to define its sensitivity and specificity.

Keywords: Inflammatory bowel disease; positron emission tomography/magnetic resonance imaging; standard uptake value.

MeSH terms

  • Adult
  • Female
  • Fluorodeoxyglucose F18
  • Humans
  • Inflammatory Bowel Diseases / diagnostic imaging*
  • Inflammatory Bowel Diseases / pathology
  • Magnetic Resonance Imaging*
  • Male
  • Multimodal Imaging*
  • Positron-Emission Tomography*
  • Predictive Value of Tests
  • Prospective Studies
  • Radiopharmaceuticals
  • Young Adult

Substances

  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18