Inflammatory bowel diseases (IBD), such as Crohn’s disease or ulcerative colitis are typically detected by endoscopic exams with histologic examinations but newly published research in the May issue of The Journal of Nuclear Medicine suggest PET/CT may offer a more effective way to diagnose and monitor these patients. Both diseases are chronic-remittent, inflammatory conditions where the patient experiences diarrhea, abdominal pain and weight loss among other symptoms. Together, Crohn’s disease and ulcerative colitis are estimated to affect 1.4 million Americans, indicating the sizeable need for new and more effective ways of diagnosing and monitoring their progression and treatment.
In the new study called “Transitional 18F-FDG PET/CT Imaging to Monitor Lesion Activity in Intestinal Inflammation” researchers have determined that PET/CT can identify lesions along the wall of the intestine that traditional imaging techniques could miss. Traditionally, assessing mucosal disease activity is a valuable way to monitor treatment response, with mucosal healing being a major treatment goal
The study evaluated 18F-FDG PET/CT as a noninvasive approach to assess IBD activity in small animals and confirmed its use by analyzing PET/CT scans conducted in patients with Crohn’s disease. In the first phase of the study, dextran sodium sulfate (DSS) colitis was induced in mice and assessed the 18F-FDG uptake in multiple sections of the colon. The mice injected with DSS were compared to control mice and the DSS mice showed an increase in 18F-FDG especially in the medial and distal colon. Also identified were extraintestinal alterations, such as bone marrow activation.
The results of this researched showed the extent of mucosal damage correlated best to 18F-FDG uptake in mice and in humans with Crohn’s disease. In Crohn’s disease patients, 18F-FDG PET/CT seemed to accurately detect advanced inflammatory changes and also unmask subepithelial disease activity that might have been missed by colonoscopy.
Dominik Bettenworth, MD, lead author of the study stated that“… PET/CT might serve as an additional tool for evaluating disease activity in IBD patients, e.g., in defining complete remission.”
The study also suggests that by using a nuclear tracer, the translation of this approach into a daily routine could benefit patients in the near future and will help further promote the use of PET/CT.