Abstract

PurposeTo investigate if texture analysis parameters of contrast-enhanced MRI differ according to the presence of histological markers of hypoxia and angiogenesis in Crohn’s disease (CD).MethodsSeven CD patients (mean age 38 (19–75), 3 male)) undergoing ileal resection underwent 3T MR enterography including axial ultrafast spoiled gradient-echo T1 post IV gadolinium chelate. Regions of interest were placed in bowel destined for resection and registered to trans-mural histological sections (n = 28 across 7 bowel sections) via MRI of the resected specimen. Microvessel density (MVD) and staining for markers of hypoxia (HIF 1α) and angiogenesis (VEGF) were performed. Texture analysis features were derived utilizing an image filtration-histogram technique at spatial scaling factor (SSF) 0–6 mm, including mean, standard deviation, mean of positive pixels, entropy, kurtosis and skewness and compared according to the presence or absence of histological markers of hypoxia/angiogenesis using Mann–Whitney U/Kruskal–Wallis tests and with the log of MVD using simple linear regression.ResultsMean, standard deviation and mean of positive pixels were significantly lower in sections expressing VEGF. For example at SSF 6 mm, median (inter-quartile range) of mean, standard deviation and mean of positive pixels in those with VEGF expression were 150.1 (134.7), 132.4 (49.2) and 184.0 (91.4) vs. 362.5 (150.2), 216.3 (100.1) and 416.6 (80.0) in those without (p = 0.001, p = 0.004 and p = 0.001), respectively. There was a significant association between skewness and MVD (ratio 1.97 (1.15–3.41)) at SSF = 2 mm.ConclusionsContrast-enhanced MRI texture analysis features significantly differ according to the presence or absence of histological markers of hypoxia and angiogenesis in CD.

Highlights

  • To investigate if texture analysis parameters of contrast-enhanced magnetic resonance imaging (MRI) differ according to the presence of histological markers of hypoxia and angiogenesis in Crohn’s disease (CD)

  • The purpose of this prospective study was to investigate any significant differences between metrics obtained by texture analyses of contrast-enhanced Magnetic resonance enterography (MRE) sequences (MRTA) in adult patients with small bowel CD according to the presence of histological markers of hypoxia and angiogenesis obtained from the same location

  • The region of interest (ROI) employed for MRTA contained a mean of 858 pixels

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Summary

Introduction

To investigate if texture analysis parameters of contrast-enhanced MRI differ according to the presence of histological markers of hypoxia and angiogenesis in Crohn’s disease (CD). The filtration-histogram technique is a commonly employed approach whereby image filtration extracts features of different sizes which allows the histogram distribution of grey-scale levels and/or pixel intensity on computed tomography (CT) and magnetic resonance imaging (MRI) to be quantified subsequently [16] These features may reflect underlying tissue structure, at least in part. It is possible that TA of contrast-enhanced MRI images could phenotype CD vasculopathy The purpose of this prospective study was to investigate any significant differences between metrics obtained by texture analyses of contrast-enhanced MRE sequences (MRTA) in adult patients with small bowel CD according to the presence of histological markers of hypoxia and angiogenesis obtained from the same location

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