Dong LW, Chen HJ, Chen CC, Lan C. Value of dual energy computed tomography with material decomposition algorithm in assessing intestinal creeping fat in Crohn’s disease. World J Radiol 2026; 18(6): 122056 [DOI: 10.4329/wjr.122056]
Corresponding Author of This Article
Cheng Lan, MD, Chief Physician, Professor, Department of Gastroenterology, Hainan General Hospital, Hainan Medical University Hainan Hospital, No. 19 Xiuhua Road, Xiuying District, Haikou 570311, Hainan Province, China. lancheng71@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
research-article
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
Share the Article
Dong LW, Chen HJ, Chen CC, Lan C. Value of dual energy computed tomography with material decomposition algorithm in assessing intestinal creeping fat in Crohn’s disease. World J Radiol 2026; 18(6): 122056 [DOI: 10.4329/wjr.122056]
World J Radiol. Jun 28, 2026; 18(6): 122056 Published online Jun 28, 2026. doi: 10.4329/wjr.122056
Value of dual energy computed tomography with material decomposition algorithm in assessing intestinal creeping fat in Crohn’s disease
Li-Wei Dong, Hui-Juan Chen, Chao-Chao Chen, Cheng Lan
Li-Wei Dong, Hui-Juan Chen, Department of Radiology, Hainan General Hospital, Hainan Medical University Hainan Hospital, Haikou 570311, Hainan Province, China
Chao-Chao Chen, Cheng Lan, Department of Gastroenterology, Hainan General Hospital, Hainan Medical University Hainan Hospital, Haikou 570311, Hainan Province, China
Author contributions: Dong LW performed most of the experiments; Dong LW, Chen HJ, and Chen CC collected and analyzed the data; Dong LW and Lan C wrote the manuscript; Lan C supervised and coordinated the project; and all authors have read and approved the final manuscript.
AI contribution statement: No AI tool was involved in the generation of research data, interpretation of results, or formulation of conclusions.
Supported by the National Natural Science Foundation of China, No. 82060102 and No. 82560109; Natural Science Foundation of Hainan Province, High-level Personnel Program, No. 822RC818; and Research Project of Health Industry in Hainan Province, No. 20A200172.
Institutional review board statement: This study was approved by the Medical Ethics Committee of Hainan General Hospital, approval No. [2023] 627.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.
Corresponding author: Cheng Lan, MD, Chief Physician, Professor, Department of Gastroenterology, Hainan General Hospital, Hainan Medical University Hainan Hospital, No. 19 Xiuhua Road, Xiuying District, Haikou 570311, Hainan Province, China. lancheng71@163.com
Received: April 14, 2026 Revised: May 10, 2026 Accepted: May 19, 2026 Published online: June 28, 2026 Processing time: 71 Days and 20.8 Hours
Abstract
BACKGROUND
While next-generation dual-energy computed tomography (DECT) has demonstrated utility for fat quantification in various clinical applications, its potential to characterize intestinal creeping fat (CrF) and to correlate these imaging finding with specific molecular pathways in Crohn’s disease (CD) remains poorly studied.
AIM
To assess the value of DECT with the material decomposition (MMD) algorithm in quantifying CrF in patients with CD, and to explore the impact of CrF on intestinal inflammation, fibrosis, adipogenesis, and expression of mucosal barrier-related genes.
METHODS
Patients with active or quiescent CD and healthy controls were included for clinical, endoscopic, and DECT imaging assessments. The MMD algorithm was used to quantify CrF. Inflammatory and fibrotic changes were scored histologically. Expression of tumor necrosis factor-α, transforming growth factor-β, peroxisome proliferator-activated receptor gamma 2, and occludin was measured by immunohistochemistry and quantitative real-time polymerase chain reaction.
RESULTS
DECT provided high-quality images and allowed quantification of CrF. CrF volume was significantly higher in active CD patients than in healthy controls (104.67 ± 26.51 vs 17.24 ± 5.16, P < 0.05). In quiescent CD, CrF volume decreased compared with active CD (32.69 ± 11.42 vs 104.67 ± 26.51, P < 0.05) but remained above control levels (P < 0.05). These changes correlated strongly with clinical and pathological indicators, including CDAI (r = 0.927), endoscopic score (r = 0.904), histologic inflammation score (r = 0.917), and fibrosis score (r = 0.932). Furthermore, CrF volume was positively correlated with peroxisome proliferator-activated receptor gamma 2 expression (r = 0.917) and negatively correlated with occludin expression (r = -0.926).
CONCLUSION
DECT with the MMD algorithm can effectively quantify intestinal CrF in CD. The quantified CrF correlates well with clinical, endoscopic, histopathological, and molecular indicators of disease activity and intestinal barrier dysfunction. This approach may serve as a useful noninvasive tool for assessing CD.
Core Tip: This study evaluated the utility of dual-source computed tomography with the material decomposition algorithm in quantifying intestinal creeping fat (CrF) in Crohn’s disease (CD). Patients with active and quiescent CD underwent clinical, endoscopic, and imaging assessments. Our results demonstrate that the volume of CrF strongly correlates with clinical, endoscopic, and histological scores for both inflammation and fibrosis. Moreover, we also found that higher CrF volume is associated with increased expression of the adipogenic factor peroxisome proliferator-activated receptor gamma 2 and reduced levels of the barrier protein occludin, providing a valuable non-invasive tool for assessing disease activity and treatment response.
