Quantitative contrast-enhanced ultrasound for monitoring vedolizumab therapy in inflammatory bowel disease patients: a pilot study.
Background Microvascularization of the bowel wall can be visualized and quantified non-invasively by software-assisted analysis of derived time-intensity curves. Purpose To perform software-based quantification of bowel wall perfusion using quantitative contrast-enhanced ultrasound (CEUS) according to clinical response in patients with inflammatory bowel disease treated with vedolizumab. Material and Methods In a prospective study, in 18 out of 34 patients, high-frequency ultrasound of bowel wall thickness using color Doppler flow combined with CEUS was performed at baseline and after 14 weeks of treatment with vedolizumab. Clinical activity scores at week 14 were used to differentiate between responders and non-responders. CEUS parameters were calculated by software analysis of the video loops. Results Nine of 18 patients (11 with Crohn's disease and seven with ulcerative colitis) showed response to treatment with vedolizumab. Overall, the responder group showed a significant decrease in the semi-quantitative color Doppler vascularization score. Amplitude-derived CEUS parameters of mural microvascularization such as peak enhancement or wash-in rate decreased in responders, in contrast with non-responders. Time-derived parameters remained stable or increased during treatment in all patients. Conclusion Analysis of bowel microvascularization by CEUS shows statistically significant changes in the wash-in-rate related to response of vedolizumab therapy.
['Goertz|Ruediger S|RS|', 'Klett|Daniel|D|', 'Wildner|Dane|D|https://orcid.org/0000-0002-4916-6533', 'Atreya|Raja|R|', 'Neurath|Markus F|MF|', 'Strobel|Deike|D|']
D000328:Adult D061067:Antibodies, Monoclonal, Humanized D015415:Biomarkers D003287:Contrast Media D005260:Female D006801:Humans D015212:Inflammatory Bowel Diseases D008297:Male D008875:Middle Aged D010743:Phospholipids D010865:Pilot Projects D011446:Prospective Studies D012984:Software D013459:Sulfur Hexafluoride D018615:Ultrasonography, Doppler, Color
contrast-enhanced ultrasound vedolizumab quantification CEUS ulcerative colitis Crohn’s disease