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Abdominal Radiology

, Volume 44, Issue 9, pp 3006–3018 | Cite as

Can ADC be used as a surrogate marker of response to therapy in intestinal tuberculosis?

  • Preeti Mathur
  • Raju SharmaEmail author
  • Devasenathipathy Kandasamy
  • Saurabh Kedia
  • Shivanand Gamanagatti
  • Vineet Ahuja
Hollow Organ GI
  • 56 Downloads

Abstract

Purpose

To evaluate the utility of Diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) in assessing treatment response in patients of intestinal tuberculosis (ITB).

Method and materials

MR Enterography (MRE) was done for patients with suspicion of ITB and 19 patients with pre- and post-treatment imaging were included in the analysis. MRE included T1W, T2W, post-contrast T1W, and DWI sequences. DWI was done using b values—0, 400 and 800 s/mm2, and ADC maps were generated. The trace DW images and ADC values were compared before and after therapy. Composite gold standard (clinical, colonoscopic criteria, and biopsy) was used to assess treatment response and to classify into no response, partial response, and complete response.

Results

Thirty-one bowel segments were evaluated at baseline and after treatment in 19 patients. Prior to therapy, restricted diffusion was seen in 29/31 (93.5%) segments. After treatment, patients with either complete or partial response (27/31 segments, 15 patients) showed significant rise in mean ADC values from 1.1 ± 0.37 × 10−3 to 2.1 ± 0.64 × 10−3 mm2/s (p value < 0.05), whereas no significant change was found in mean ADC values of non-responders (4/29 segments in 4 patients) which increased from 1.0 ± 0.1 × 10−3 mm2/s on baseline scan to 1.32 ± 0.2 × 10−3 mm2/s on post-treatment scan (p value = 0.318). An increase in ADC value was found to be a reliable and objective marker of improvement with response to therapy.

Conclusion

ADC values show good correlation with treatment response in ITB and can be used for objectively quantifying it.

Keywords

MR enterography DWI Intestinal tuberculosis ADC Treatment response 

Notes

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Preeti Mathur
    • 1
  • Raju Sharma
    • 1
    • 3
    Email author
  • Devasenathipathy Kandasamy
    • 1
  • Saurabh Kedia
    • 2
  • Shivanand Gamanagatti
    • 1
  • Vineet Ahuja
    • 2
  1. 1.Department of RadiodiagnosisAll India Institute of Medical SciencesNew DelhiIndia
  2. 2.Department of GastroenterologyAll India Institute of Medical SciencesNew DelhiIndia
  3. 3.Department of RadiodiagnosisAll India Institute of Medical SciencesNew DelhiIndia

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