Published online Jan 21, 2025. doi: 10.3748/wjg.v31.i3.102283
Revised: November 19, 2024
Accepted: December 3, 2024
Published online: January 21, 2025
Processing time: 67 Days and 11.4 Hours
Mucosal healing (MH) is the major therapeutic target for Crohn's disease (CD). As the most commonly involved intestinal segment, small bowel (SB) assessment is crucial for CD patients. Yet, it poses a significant challenge due to its limited accessibility through conventional endoscopic methods.
To establish a noninvasive radiomic model based on computed tomography enterography (CTE) for MH assessment in SBCD patients.
Seventy-three patients diagnosed with SBCD were included and divided into a training cohort (n = 55) and a test cohort (n = 18). Radiomic features were obtained from CTE images to establish a radiomic model. Patient demographics were analysed to establish a clinical model. A radiomic-clinical nomogram was constructed by combining significant clinical and radiomic features. The diagnostic efficacy and clinical benefit were evaluated via receiver operating characteristic (ROC) curve analysis and decision curve analysis (DCA), re
Of the 73 patients enrolled, 25 patients achieved MH. The radiomic-clinical nomogram had an area under the ROC curve of 0.961 (95% confidence interval: 0.886-1.000) in the training cohort and 0.958 (0.877-1.000) in the test cohort and provided superior clinical benefit to either the clinical or radiomic models alone, as demonstrated by DCA.
These results indicate that the CTE-based radiomic-clinical nomogram is a promising imaging biomarker for MH and serves as a potential noninvasive alternative to enteroscopy for MH assessment in SBCD patients.
Core Tip: Mucosal healing (MH) of small bowel (SB) in Crohn's disease (CD) is difficult to assess due to its limited accessibility through conventional endoscopic methods. Radiomics is a novel tool and has a good performance in disease diagnosis and efficacy evaluation. Here, we developed a computed tomography enterography-based radiomic-clinical nomogram to assess MH for SBCD patients with an area under the receiver operating characteristic curve of 0.961 in the training cohort and 0.958 in the test cohort, highlighting the potential of radiomics as an imaging biomarker and a noninvasive alternative to enteroscopy for MH assessment in SBCD.