Imaging technology might help doctors determine best treatment for Crohn's disease patients
It's difficult for doctors to tell whether a patient with Crohn's disease has intestinal fibrosis, which requires surgery, or inflammation, which can be treated with medicine. A new imaging method might make that task easier, according to a U-M-led study.
Ultrasound elasticity imaging, or UEI, could allow doctors to noninvasively make the distinction between inflammation and fibrosis, allowing patients to receive more appropriate and timely care. The study was published in the September edition of Gastroenterology.
Crohn's disease patients suffer from chronic inflammation of the intestines, which over time can cause scar tissue to form, resulting in intestinal fibrosis.
Patients with intestinal inflammation usually are treated with medicines that suppress their immune system, while patients with fibrosis are treated surgically. Because current diagnostic tests, including CT scans and MRIs, cannot detect the difference between the two conditions, many patients with fibrosis are often initially treated with immune system-suppressing drugs, which are expensive and are unlikely to help.
"These therapies are potent, costly and carry risk," says Ryan Stidham, M.D., clinical lecturer in the Department of Internal Medicine. "And for patients with fibrosis, such treatment might be for naught."
Inflamed intestinal tissue is softer than fibrotic tissue, which is hard and thick. The new method uses ultrasound to measure the relative hardness and thickness of tissue inside the body, potentially allowing doctors to differentiate between the two conditions without performing surgery. In animal models, UEI was able to accurately tell the difference between inflamed tissue and scar tissue.
"The goal of this study is to have technology that can make the distinction between fibrosis and inflammation," says Stidham, the lead author of the study. "We want to know if it's worth it to push medical therapy, or if a person is destined for surgery."
The researchers also found that UEI was capable of differentiating between fibrotic and unaffected intestine in a pilot human study. Patients already scheduled for surgical treatment underwent UEI assessment prior to surgery, and fibrotic strictures were identified in each case.
Stidham says the next step in the group's research is a long-term human clinical trial, beginning this winter. If UEI is able to accurately assess a patient's condition, doctors will be able to more efficiently treat Crohn's disease patients suffering from inflammation or fibrosis.
"UEI has great potential to provide a clear measurement that helps clinicians judge whether medical or surgical management is best for the individual patient earlier in their disease course." Stidham says.
More information: Gastroenterology, DOI:10.1053/j.gastro.2011.07.027 ; published online July 25, 2011. "Ultrasound Elasticity Imaging for Detecting Intestinal Fibrosis and Inflammation in Rats and Humans With Crohn's Disease"
Provided by University of Michigan
- Scarred lungs leave trail of beta arrestins Mar 28, 2011 | not rated yet | 0
- Novel criteria to differentiate fibrosis from steatohepatitis Mar 05, 2010 | not rated yet | 0
- Study shows why treatment isn't effective for HIV Aug 05, 2008 | not rated yet | 0
- Cancer drug may also work for scleroderma Sep 22, 2011 | not rated yet | 0
- Targeted delivery of losartan reduces liver inflammation and scarring Mar 01, 2010 | not rated yet | 0
- Motion perception revisited: High Phi effect challenges established motion perception assumptions Apr 23, 2013 | 3 / 5 (2) | 2
- Anything you can do I can do better: Neuromolecular foundations of the superiority illusion (Update) Apr 02, 2013 | 4.5 / 5 (11) | 5
- The visual system as economist: Neural resource allocation in visual adaptation Mar 30, 2013 | 5 / 5 (2) | 9
- Separate lives: Neuronal and organismal lifespans decoupled Mar 27, 2013 | 4.9 / 5 (8) | 0
- Sizing things up: The evolutionary neurobiology of scale invariance Feb 28, 2013 | 4.8 / 5 (10) | 14
Classical and Quantum Mechanics via Lie algebras
Apr 15, 2011 I'd like to open a discussion thread for version 2 of the draft of my book ''Classical and Quantum Mechanics via Lie algebras'', available online at http://lanl.arxiv.org/abs/0810.1019 , and for the...
- More from Physics Forums - Independent Research
More news stories
Gourmands and foodies everywhere have long recognized ginger as a great way to add a little peppery zing to both sweet and savory dishes; now, a study from researchers at Columbia University shows purified components of the ...
Diseases, Conditions, Syndromes 9 hours ago | not rated yet | 0
There are significant cost and risk factors associated with two procedures commonly used to diagnose or treat gastrointestinal problems, according to research presented at Digestive Disease Week (DDW).
Diseases, Conditions, Syndromes 21 hours ago | not rated yet | 0
Regular consumption of coffee is associated with a reduced risk of primary sclerosing cholangitis (PSC), an autoimmune liver disease, Mayo Clinic research shows. The findings were being presented at the Digestive Disease ...
Diseases, Conditions, Syndromes 21 hours ago | not rated yet | 0 |
A new case of the deadly coronavirus has been detected in Saudi Arabia where 15 people have already died after contracting it, the health ministry announced on Saturday on its Internet website.
Diseases, Conditions, Syndromes May 18, 2013 | not rated yet | 0
(HealthDay)—Few randomized clinical trials have been done to assess clinical prediction rules for patients with lower back pain, and the trials that have been done are of low quality and do not provide ...
Diseases, Conditions, Syndromes May 17, 2013 | not rated yet | 0 |
Researchers at the University of Wisconsin have identified a potential new risk factor for obstructive sleep apnea: asthma. Using data from the National Institutes of Health (Heart, Lung, and Blood Institute)-funded Wisconsin ...
9 hours ago | not rated yet | 0 |
In their quest to learn more about the variability of cells between and within tissues, biomedical scientists have devised tools capable of simultaneously measuring dozens of characteristics of individual ...
10 hours ago | 5 / 5 (2) | 0 |
Scientists at Johns Hopkins have turned their view of osteoarthritis (OA) inside out. Literally. Instead of seeing the painful degenerative disease as a problem primarily of the cartilage that cushions joints, ...
10 hours ago | 4.8 / 5 (4) | 0 |
A new study looking at sleep-disordered breathing (SDB) and markers for Alzheimer's disease (AD) risk in cerebrospinal fluid (CSF) and neuroimaging adds to the growing body of research linking the two.
9 hours ago | 5 / 5 (2) | 0 |
The hunt for an HIV vaccine has gobbled up $8 billion in the past decade, and the failure of the most recent efficacy trial has delivered yet another setback to 26 years of efforts.
14 hours ago | not rated yet | 0
Patients with treatment-resistant major depression saw dramatic improvement in their illness after treatment with ketamine, an anesthetic, according to the largest ketamine clinical trial to-date led by researchers from the ...
21 hours ago | 4.8 / 5 (5) | 1 |