Magnetic resonance imaging-quantified small bowel motility is a sensitive marker of response to medical therapy in XXXX .

@entity310 @entity1 @entity30 @entity1851
BACKGROUND: Magnetic resonance enterography (MRE) can measure small bowel motility, reduction in which reflects inflammatory burden in @entity30 ( @entity30 ). However, it is unknown if motility improves with successful treatment. AIM: To determine if changes in segmental small bowel motility reflect response to anti- @entity310 therapy after induction and longer term. METHODS: A total of 46 @entity1 (median 29  years, 19 females) underwent MRE before anti- @entity310 treatment; 35 identified retrospectively underwent repeat MRE after median 55  weeks of treatment and 11 recruited prospectively after median 12  weeks. Therapeutic response was defined by physician global assessment (retrospective group) or a >= 3 point drop in the Harvey-Bradshaw Index (prospective group), @entity1851 and the MaRIA score. Two independent radiologists measured motility using an MRE image-registration algorithm. We compared motility changes in responders and nonresponders using the Mann-Whitney test. RESULTS: Anti- @entity310 responders had significantly greater improvements in motility (median  =  73.4% increase from baseline) than nonresponders (median  =  25% reduction, P  <  0.001). Improved MRI-measured motility was 93.1% sensitive (95%CI: 78.0-98.1%) and 76.5% specific (95% CI: 52.7-90.4%) for anti- @entity310 response. @entity1 with @entity1851 normalisation (<5  mg/L) had significantly greater improvements in motility (median  =  73.4% increase) than those with persistently elevated @entity1851 (median  =  5.1%, P  =  0.035). Individuals with post-treatment MaRIA scores of <11 had greater motility improvements (median  =  94.7% increase) than those with post-treatment MaRIA score >11 (median 15.2% increase, P  =  0.017). CONCLUSIONS: Improved MRI-measured small bowel motility accurately detects response to anti- @entity310 therapy for @entity30 , even as early as 12  weeks. Motility MRI may permit early identification of nonresponse to anti- @entity310 agents, allowing personalised treatment.
