SFMR:s företagsstipendium: Kristin Johnsson

Could 3D analysis of perianal fistulas predict treatment outcome?

Background:

Perianal fistulas represent an aggressive disease course in Crohn’s disease and cause severe impact on quality of life. Perianal fistula treatment is complex and include medical treatment and/or surgical treatment. There is classification systems based on magnetic resonance imaging (MRI), among them the Parks classification system. However, there is a lack of tools to predict which patients would benefit the most from surgery.

Aim:

To evaluate if volume assessment of MRI images with a commercially available, FDA and CE-approved 3D platform (Entrolytics® by Motilent®) can predict treatment outcome in perianal fistulizing Crohn´s disease.

Methods:

All adult patients with a diagnosis of Crohn’s disease and perianal fistulas, who have undergone MRI pelvis between 2014 and 2023, will be selected through a database at the IBD Leuven research center. Treatment outcome will be defined as closure at one year follow-up. The pelvic MRI images of the study participants will be read by an abdominal radiologist and classified according to the Parks classification. Volume assessment of fistulas by Entrolytics® will be performed. Differences in mean volume and outcome will be compared using t-test. Uni- and multivariate regression models will be used to determine which parameters have predictive value of fistula closure.

Clinical applications:

Identifying patients who would benefit from surgery by 3D-aided analysis of MRI images can lead to improved treatment of perianal fistulas, and also avoid invasive treatment and side effects in patients who do not benefit from surgery.