The British journal of radiology · 2026
pTRACK-generated normalized average T2 signal intensity and fistula volume are accurate and sensitive measures of perianal Crohn's disease activity.
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Naim Iyad, Greer Christian, Bhatnagar Gauraang, Hoad Caroline, Evans Jon, Poon Dennis, Radford Shellie, Tucknott Seb, Menys Alex, Moran Gordon William
Аннотация
OBJECTIVES: Fistula T2 signal intensity and volume are predictive of treatment response in IBD. We aimed to evaluate pTRACK-generated MRI metrics against MAGNIFI-CD, assessing predictive value for clinical outcomes.
METHODS: MRI and clinical assessment cases of 46 patients with pCD were included. T2 signal intensity was normalized using ROI in adjacent pelvic muscles. Clinical outcomes were scored using physician global assessment. Correlations, unpaired 2-tailed t-tests, and receiver operating characteristics curve analyses performance metrics were used to compare MRI metrics and predict PGA categories.
RESULTS: Normalized average T2 signal intensity demonstrated AUC 0.784 (95% CI: 0.648-0.893). Optimal threshold for classification was 1.527, with accuracy of 80.0%, with high sensitivity (0.857) and moderate specificity (0.632). MAGNIFI-CD scores (ICC = 0.87, 95% CI: 0.45-0.98, P = .0014), fistula volume (ICC = 0.81, 95% CI: 0.21-0.97, P = .0103) showed good-excellent reliability. Significant differences were observed when dichotomized into remission and active groups: T2 signal intensity (1.55 ms ± 0.88 vs. 2.87 ms ± 1.42, P < .001), fistula volume (2.0 ± 3.3 mL vs. 4.3 ± 8.7 mL, P = .04) and MAGNIFI-CD (5.86 ± 4.70 vs. 12.41 ± 5.80, P < .001).
CONCLUSIONS: pTRACK's normalized T2 signal demonstrated comparable accuracy to MAGNIFI-CD, with higher sensitivity for predicting pCD activity. These findings underscore pTRACK's potential utility, warranting prospective validation in cohorts with more severe disease.
ADVANCES IN KNOWLEDGE: pTRACK enables radiologists to measure fistula volume, normalized average T2 signal intensity, and generate 3D digital models, and has shown comparable accuracy to MAGNIFI-CD.
METHODS: MRI and clinical assessment cases of 46 patients with pCD were included. T2 signal intensity was normalized using ROI in adjacent pelvic muscles. Clinical outcomes were scored using physician global assessment. Correlations, unpaired 2-tailed t-tests, and receiver operating characteristics curve analyses performance metrics were used to compare MRI metrics and predict PGA categories.
RESULTS: Normalized average T2 signal intensity demonstrated AUC 0.784 (95% CI: 0.648-0.893). Optimal threshold for classification was 1.527, with accuracy of 80.0%, with high sensitivity (0.857) and moderate specificity (0.632). MAGNIFI-CD scores (ICC = 0.87, 95% CI: 0.45-0.98, P = .0014), fistula volume (ICC = 0.81, 95% CI: 0.21-0.97, P = .0103) showed good-excellent reliability. Significant differences were observed when dichotomized into remission and active groups: T2 signal intensity (1.55 ms ± 0.88 vs. 2.87 ms ± 1.42, P < .001), fistula volume (2.0 ± 3.3 mL vs. 4.3 ± 8.7 mL, P = .04) and MAGNIFI-CD (5.86 ± 4.70 vs. 12.41 ± 5.80, P < .001).
CONCLUSIONS: pTRACK's normalized T2 signal demonstrated comparable accuracy to MAGNIFI-CD, with higher sensitivity for predicting pCD activity. These findings underscore pTRACK's potential utility, warranting prospective validation in cohorts with more severe disease.
ADVANCES IN KNOWLEDGE: pTRACK enables radiologists to measure fistula volume, normalized average T2 signal intensity, and generate 3D digital models, and has shown comparable accuracy to MAGNIFI-CD.