New imaging procedure instead of invasive diagnostic measures
Intestinal tissue changes in patients suffering from Crohn's disease can now be reliably diagnosed on the basis of an innovative method called 'elastography'. Scientists at the Charité – Universitätsmedizin Berlin have documented this breakthrough in a recent study, which has now been published in the professional journal Radiology*. The deployment of this ultrasound-based and non-invasive method will eventually help doctors to objectify the success of therapy and to select the best possible timeframe for surgery.
Crohn's disease is a chronic inflammatory disorder, which results from an inappropriate immune response to the commensal microbiota in genetically susceptible individuals. The disease not only emerges in the various segments of the digestive tract, it also takes the form of a systemic immune disease, one that can also affect all bodily organs. In this process the intestinal mucosa and other organs become permanently inflamed and not just superficially ─ the deeper layers are also affected. Approximately two-thirds of all patients develop scarring of the intestinal wall over the course of their disease. The ensuing constricted areas must undergo surgery to remove small segments of the intestines in cases where medical therapy is ineffective. Until now, radiological exams with contrast media or a colonoscopy involving a tissue sampling have been used to facilitate an objective assessment of the condition of the intestinal tissues and the success of medical therapy. A non-invasive assessment of the mechanical tissue properties of the gut has not been possible to date in humans.
In the context of their study, scientists carrying out the research with Prof. Daniel C. Baumgart heading the Inflammatory Bowel Disease Center at the Department of Hepatology and Gastroenterology have now for the first time investigated the use of elastography in patients with Crohn's disease. Elastography is a new imaging procedure that expands the advantages of both ultrasound diagnostics and magnetic resonance imaging (MRI). Doctors applied various methods to assess the condition of healthy and diseased intestinal tissue obtained from sick patients before, during and after surgery. The investigators were able to demonstrate that a strong correlation exists between the data generated by elastography and those determined using conventional physical methods.
"Our findings show that elastography satisfies all the prerequisites to further develop the procedure into a reliable method, indeed one that is able to objectively assess mechanical intestinal tissue properties without the need for tissue samples or contrast media. This is a decisive step on the road to achieving a more individualized and sustainable treatment approach for patients with Crohn's disease ", concludes Prof. Baumgart, who was recently selected by the Stiftung Charité (Charitable Foundation of the Charité) to serve as a Fellow at the Berlin Institute of Health (BIH). He adds: "The development of a physical method to assess the properties of human tissue in daily clinical practice is a notable example of how research findings can be successfully translated to meet real clinical needs".
*Baumgart DC, Müller HP, Grittner U, Metzke D, Fischer A, Guckelberger O, Pascher A, Sack I, Vieth M, Rudolph B. US-based Real-time Elastography for the Detection of Fibrotic Gut Tissue in Patients with Stricturing Crohn Disease. Radiology. 2015 Feb 6:141929. doi: 10.1148/radiol.14141929.
Prof. Daniel C. Baumgart
Medizinische Klinik mit Schwerpunkt Hepatologie und Gastroenterologie
t: +49 30 450 553 277
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