Imperial College London
Alternate

ProfessorRobinPhillips

Faculty of Medicine, Department of Surgery & Cancer

Emeritus Professor of Colorectal Surgery
 
 
 
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Contact

 

+44 (0)1923 827 988robin.phillips

 
 
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Location

 

St Marks HospitalNorthwick Park and St Marks Site

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Summary

 

Publications

Citation

BibTex format

@article{Lung:2018:10.1177/175628418793609,
author = {Lung, PFC and Sahnan, K and Burling, D and Burn, J and Tozer, P and Yassin, N and Adegbola, SO and Baldwin-Cleland, R and Warusavitarne, J and Gupta, A and Faiz, O and Phillips, RKS and Hart, AL},
doi = {10.1177/175628418793609},
journal = {Therapeutic Advances in Gastroenterology},
pages = {1--8},
title = {Volume assessment magnetic resonance imaging technique for monitoring perianal Crohn's fistulas},
url = {http://dx.doi.org/10.1177/175628418793609},
volume = {11},
year = {2018}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Background:Perianal Crohn’s fistula and their response to anti-tumour necrosis factor (TNF) therapies are best assessed with magnetic resonance imaging (MRI), but radiologist reporting is subjective and variable. This study investigates whether segmentation software could provide precise and reproducible objective measurements of fistula volume.Methods:Retrospective analysis of patients with perianal Crohn’s fistula at our institution between 2007 and 2013. Pre- and post-biologic MRI scans were used with varying time intervals. A total of two radiologists recorded fistula volumes, mean signal intensity and time taken to measure fistula volumes using validated Open Source segmentation software. A total of three radiologists assessed fistula response to treatment (improved, worse or unchanged) by comparing MRI scans.Results:A total of 18 cases were reviewed for this pilot study. Inter-observer variability was very good for volume and mean signal intensity; intra-class correlation (ICC) 0.95 [95% confidence interval (CI) 0.91–0.98] and 0.95 (95% CI 0.90–0.97) respectively. Intra-observer variability was very good for volume and mean signal intensity; ICC 0.99 (95% CI 0.97–0.99) and 0.98 (95% CI 0.95–0.99) respectively. Average time taken to measure fistula volume was 202 s and 250 s for readers 1 and 2. Agreement between three specialist radiologists was good [kappa 0.69 (95% CI 0.49–0.90)] for the subjective assessment of fistula response. Significant association was found between objective percentage volume change and subjective consensus agreement of response (p=0.001). Median volume change for improved, stable or worsening fistula response was −67% [interquartile range (IQR): −78, −47], 0% (IQR: −16, +17), and +487% (IQR: +217, +559) respectively.Conclusion:Quantification of fistula volumes and signal intensities is feasible and reliable, providing an objective measure of perianal Crohn’s fis
AU  - Lung,PFC
AU  - Sahnan,K
AU  - Burling,D
AU  - Burn,J
AU  - Tozer,P
AU  - Yassin,N
AU  - Adegbola,SO
AU  - Baldwin-Cleland,R
AU  - Warusavitarne,J
AU  - Gupta,A
AU  - Faiz,O
AU  - Phillips,RKS
AU  - Hart,AL
DO  - 10.1177/175628418793609
EP  - 8
PY  - 2018///
SN  - 1756-2848
SP  - 1
TI  - Volume assessment magnetic resonance imaging technique for monitoring perianal Crohn's fistulas
T2  - Therapeutic Advances in Gastroenterology
UR  - http://dx.doi.org/10.1177/175628418793609
UR  - http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000443205900001&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
UR  - http://hdl.handle.net/10044/1/62276
VL  - 11
ER  -
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