A new MR-based Perianal Crohn’s disease activity score: A multi-centre study (The MAP study)
24th November 2016 - ongoing
Status: In Recruitment
Specialism: Imaging, MR Imaging, Lower GI, Inflammatory Bowel Disease (IBD).
Perianal Crohn’s disease (pCD) affects a fifth of Crohn’s disease patients with a third experiencing recurrent symptoms. It involves inflammation in the anorectum leading to fistulisation through the perineum to adjacent viscera or skin, formation of perianal abscesses causing severe pain and faecal incontinence with a significant impairment in the quality of life of patients who are often teenagers or young adults.
We believe that we have the capability to provide a means to help in managing this very distressing condition.
It is very difficult to quantify inflammation within perianal fistulas. Disease activity is measured through insensitive clinical scores. Conventional 1.5T Magnetic Resonance (MR) imaging is the best modality available for pCD monitoring but still correlates poorly to disease activity. This leads to poor treatment optimisation and delayed or premature treatment cessation associated with adverse outcomes. In the absence of a sensitive disease marker, there is a paucity of good clinical studies with poor clinical evidence in this field.
New MR disease activity measures are needed. Magnetisation transfer techniques, dynamic contrast enhancement, fistula volumetrics and diffusion-weighted imaging have all shown promise in monitoring disease activity.
We will recruit subjects with pCD before the onset of biological therapy and quantify disease activity before treatment onset and 12 weeks after therapy using an array of quantitative MR markers at 1.5T. Imaging at 3T will provide higher spatial resolution and greater sensitivity to provide more information to inform the development of a new MR-based disease activity score for use within clinical practice.
|Dr Gordon Moran||Dr Moran did his undergraduate medical training at University of Malta Medical School and was awarded an MD in 1999. He completed his basic postgraduate training at St. Luke's Hospital in Malta and gained membership of the Royal College of Physicians of…|
|Professor Penny Gowland||Developing quantitative MRI for biomedical applications. I am particularly interested in exploiting the capabilities of functional and anatomical ultra-high field MRI in neuroscience, in using the increased contrast to noise ratio available at ultrahigh…|
|Dr Caroline Hoad|