A novel MRI scoring system for Crohn’s Perianal fistula
Research type
Research Study
Full title
Investigation of a novel MRI scoring system for the assessment of disease response in patients’ receiving biologic treatment for Crohn’s Perianal fistula.
IRAS ID
240536
Contact name
Andrew Williams
Contact email
Sponsor organisation
Guy’s and St Thomas’ NHS Foundation Trust R&D Department
Duration of Study in the UK
2 years, 0 months, 2 days
Research summary
Perianal Crohn’s disease (PCD) is considered an aggressive and disabling phenotype, which manifests in about 40% of patients diagnosed with CD. Quality of life is often compromised due to anal pain, discharge and faecal incontinence.
Once the extent and nature of the PCD is characterized combination treatment consisting of surgical and medical therapy (TNF with or without immunomodulator) results in improved rates of fistula healing compared with surgery or medical therapy alone.
In clinical practice, pelvic magnetic resonance imaging (MRI) has an established role for the evaluation of patients with perianal fistula and it is used to make clinical decisions and assess changes in disease state.
MRI is an invaluable instrument to evaluate patients with perianal Crohn’s disease and can guide medical and surgical treatment options. The actual MRI scoring systems are not sensitive enough to improvements in fistula complexity and extent and they so do not have close correlation with clinical findings.
A new MRI based scoring system for fistula has been developed and we intend to apply this score in patients with perianal Crohn’s disease and correlate the score with assessment of Quality of life (IBD-8), Perianal Disease Activity Index (PCDAI) and also with clinical findings about fistula in ano. In addition we will determine if this score is sensitive to improvements in fistula severity and extent in patients receiving combination medical treatment (biologics and immunomodulators).
The primary objective is to apply a new MRI scoring system to MRI images of patients with Perianal Crohn’s Disease and correlate the new score with Quality of life, Perianal Disease Activity index and also with clinical findings.
If the correlation between the new scoring system, quality of life and clinical findings is strong, this will be an invaluable instrument to drive patients' tretament in this chronic disease.
REC name
South Central - Berkshire B Research Ethics Committee
REC reference
18/SC/0110
Date of REC Opinion
1 Mar 2018
REC opinion
Favourable Opinion