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Evaluation of Mucosal Healing in Crohn’s Disease: Radiomics Models of Intestinal Wall and Mesenteric Fat Based on Dual-Energy CT

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Abstract

This study aims to assess the effectiveness of radiomics signatures obtained from dual-energy computed tomography enterography (DECTE) in the evaluation of mucosal healing (MH) in patients diagnosed with Crohn’s disease (CD). In this study, 106 CD patients with a total of 221 diseased intestinal segments (79 with MH and 142 non-MH) from two medical centers were included and randomly divided into training and testing cohorts at a ratio of 7:3. Radiomics features were extracted from the enteric phase iodine maps and 40-kev and 70-kev virtual monoenergetic images (VMIs) of the diseased intestinal segments, as well as from mesenteric fat. Feature selection was performed using the least absolute shrinkage and selection operator (LASSO) logistic regression. Radiomics models were subsequently established, and the accuracy of these models in identifying MH in CD was assessed by calculating the area under the receiver operating characteristic curve (AUC). The combined-iodine model formulated by integrating the intestinal and mesenteric fat radiomics features of iodine maps exhibited the most favorable performance in evaluating MH, with AUCs of 0.989 (95% confidence interval (CI) 0.977–1.000) in the training cohort and 0.947 (95% CI 0.884–1.000) in the testing cohort. Patients categorized as high risk by the combined-iodine model displayed a greater probability of experiencing disease progression when contrasted with low-risk patients. The combined-iodine radiomics model, which is built upon iodine maps of diseased intestinal segments and mesenteric fat, has demonstrated promising performance in evaluating MH in CD patients.

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Data Availability

The datasets used and analyzed during the current study are available from the corresponding author on reasonable request.

Abbreviations

AUC:

Area under the ROC curve

CTE:

Computed tomography enterography

CD:

Crohn’s disease

CRP:

C-reactive protein

DCA:

Decision curve analysis

DECTE:

Dual-energy computed tomography enterography

IFX:

Infliximab

IDI:

Integrated discrimination improvement

HBI:

Harvey Bradshaw Index

LASSO:

Least absolute shrinkage and selection operator

MH:

Mucosal healing

VOI:

Volume of interest

ROC:

Receiver operator characteristic

SVM:

Support vector machines

SES-CD:

Simple Endoscopic Score for CD

TNF:

Tumor necrosis factor

VMIs:

Virtual monoenergetic images

WBC:

White blood cell

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Funding

This work was supported by the Natural Science Foundation of Anhui Province of China (2308085MH241) and the Research Funds for Academic and Technological Leaders in Anhui Province (No. 2021D299).

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Authors and Affiliations

  1. Department of Radiology, The First Affiliated Hospital of Anhui Medical UniversityShushan DistrictAnhui Province, No. 218 Jixi Road, Hefei, 230022, People’s Republic of China

    Chao Zhu, Chang Rong, Jian Song, Xiaomin Zheng, Qi Wu & Xingwang Wu

  2. Department of Gastroenterology, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, People’s Republic of China

    Jing Hu

  3. CT Research Center, GE Healthcare China, Shanghai, 210000, People’s Republic of China

    Jianying Li

Authors
  1. Chao Zhu
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Contributions

Each author has contributed to conception and design, literature search, drafting of the article, critical revision, and final approval. Chao Zhu: conceptualization, data curation, writing and original draft. Chang Rong: conceptualization, methodology, and writing original draft. Jian Song: data curation, methodology, writing and review. Xiaomin Zheng: data curation, methodology, writing, and review. Qi Wu: data curation, methodology, writing, and review. Jing Hu: data curation, methodology, writing, and review. Jianying Li: data curation, methodology, writing, review, and editing. Xingwang Wu: conceptualization, methodology, writing, review, and editing.

Corresponding author

Correspondence to Xingwang Wu.

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Ethical Approval

This retrospective study received ethical approval from the Institutional Review Committee of the First Affiliated Hospital of Anhui Medical University.

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The requirement for informed consent for patients was waived.

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Not applicable.

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The authors declare no competing interests.

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Chao  Zhu and Chang Rong contributed equally to this work.

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Zhu, C., Rong, C., Song, J. et al. Evaluation of Mucosal Healing in Crohn’s Disease: Radiomics Models of Intestinal Wall and Mesenteric Fat Based on Dual-Energy CT. J Digit Imaging. Inform. med. 37, 715–724 (2024). https://doi.org/10.1007/s10278-024-00989-z

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