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IMPACT OF OBJECTIVE MOTILITY MRI SCORING OF ILEAL CROHN’S DISEASE ON RADIOLOGISTS DISEASE ASSESSMENT: THE CONTEXT TRIAL

Alex Menys 1, Iyad Naim 1, Gordon Moran 2, Heather Fitzke 3, Victoria Jennings 2, Sudheer K. Vuyyuru 2, Christopher Clarke 4, Rahul Munyal 4, Sara Upponi 5, Juan de la Revilla Negro 5, Tom Shepherd 6, Gauraang Bhatnagar 6, Joy Barber 7, Nirav Patel 7, Maira Hameed 3, William Weston 3, Jie Han Yeo 8, Paul Harrow 8, Attah Ocholi 7, Delara Khodabakhshi 7, Samantha Baillie 7, Nkem Onyeador 7, Kamal Patel 7, Jimmy K. Limdi 9, Karishma Sethi-Arora 9, Anish John Kuriakose Kuzhiyanjal 9, Aungzaw Win 9, Priyanka Ghodekar 9, Afaq Mohammed Siddiuqui 9, Hannah Lambie 10, Damian Tolan 10, Stuart Taylor 3

Affiliations

1 Motilent, London, United Kingdom

2 Nottingham Digestive Diseases Centre, Nottingham, United Kingdom

3 University College London, London, United Kingdom

4 Nottingham University Hospitals, Nottingham, United Kingdom

5 Addenbrooke's- University of Cambridge, Cambridge, United Kingdom

6 Frimley Park Hospital, Frimley, United Kingdom

7 St George's Hospital, London, United Kingdom

8 University College London Hospitals, London, United Kingdom

9 Northern Care Alliance NHS Foundation Trust, Manchester, United Kingdom

10 Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom

Summary

AI Generated

In a multi-center study of 277 Crohn's disease patients, quantitative small bowel motility scores (GIQuant) more frequently influenced radiologists' MRE disease assessments than IV gadolinium contrast imaging, changing disease status impressions in 19.8% versus 6% of cases respectively.

GIQuant motility scores increased radiologists' diagnostic confidence in 43% of 277 Crohn's disease cases evaluated at baseline and 1-year follow-up across six UK sites.
In the subset of 202 patients with both modalities available, GIQuant scores led to reclassification of patient disease status in 16.3% of cases compared to 5.3% for IV gadolinium.
GIQuant scores changed overall disease status impressions in 20% of cases versus 6% for IV gadolinium in head-to-head comparison.
The study authors suggest GIQuant may serve as a potential replacement for routine IV gadolinium administration in MRE assessment of Crohn's disease activity.
Multiple study authors have financial relationships with Motilent, the company that produces GIQuant.

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This summary was generated by an AI large language model based on the content transcript. It is for informational purposes only and should not be considered a substitute for clinical judgment. Always rely on your professional expertise and the full clinical context when making clinical decisions.

Abstract

Introduction

Radiological assessment of small bowel Crohn’s disease remains challenging, especially when differentiating active inflammation from chronic change. Magnetic Resonance Enterography (MRE) is central to non-invasive evaluation, with post-contrast T1-weighted imaging routinely used to help assess disease activity. However, routine use of IV gadolinium adds to examination cost and time, and increases risks to the patient, notably concerns about gadolinium retention. Furthermore, interpretation is subjective and both inflammation and fibrosis cause hyperenhancement. Quantitative motility analysis using GIQuant (Motilent, UK) provides an objective measure of small bowel motility using cine MRI and has been proposed as an alternative biomarker for disease activity, yet its influence on radiologist decision-making and diagnostic confidence in clinical practice remains largely unexplored.

Aims & Methods

Ten NHS radiologists across six UK sites identified CD patients with baseline and 1-year follow-up MR-enterography including T1-weighted post-contrast and small bowel motility sequences. For both timepoints, GIQuant motility scores were derived by placing an ROI in the most active SB segments (multiple ROIs if more than 1). Radiologists interpreted the MREs at both time points initially using standard MRE sequences, excluding GIQuant scores and post-contrast imaging, and graded overall and segmental disease status on a 5-point scale (transmural-remission, significant transmural response, stable disease, progression of disease, other). Radiologists were then asked to enter the GIQuant scores and update their segmental and overall assessment. The process was then repeated after examining IV gadolinium enhanced images. Radiologists also rated the impact of both IV gadolinium and motility scores on their diagnostic confidence using a 7-point scale: no-impact, confidence-decreased/increased, or diagnosis-changed to active/inactive.

Results

277 CD patients (60% male, mean age 35±13 yrs) scanned between Nov 2017- Aug 2024 were included. 202 had T1-weighted post-IV contrast imaging. GIQuant scores led to changes in overall disease status impression (e.g., stable disease to progression of disease or vice versa) in 55/277 (19.8%). Radiologists stated that GIQuant scores increased their diagnostic confidence in 120/277 (43%) cases. After examining the change in GIQuant scores, radiologists reclassified patient status (e.g., active to inactive or vice-versa) in 40/277 (14.4%) cases.
In comparison, unmasking to post-contrast IV Gad images led to changes in overall disease status impression in just 13/202 patients (6%) compared to 42/202 (20%) for GIQuant scores. Radiologists reclassified patient status (e.g., active to inactive or vice-versa) in just 11 (5.3%) after unmasking to post-contrast IV Gad images, compared with 33 (16.3%) for GIQuant scores.
Radiologists indicated that post-contrast IV Gad imaging impacted diagnosis or confidence in 105 (52%) of cases compared to 127 (63%) for GIQuant scores.

Conclusion

GIQuant motility scores have more impact on radiologists’ assessment of disease response on MRE compared to IV gadolinium, and improves diagnostic confidence in 43% of patients suggesting its utility as a biomarker of disease activity and response and as a potential replacement for routine IV gadolinium administration.

Disclosure

Dr. Alex Menys is the founder and CEO of Motilent.
Dr. Iyad Naim is an employee of Motilent.
Dr. Gauraang Bhatnagar serves as a consultant for Motilent.
Prof. Stuart Taylor holds share options in Motilent.

Conference

UEG Week Berlin 2025

Topics

IBD

Submission format

Abstract

Session

Imaging in IBD (Posters)

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

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