Characteristics and usefulness of transabdominal ultrasonography in immune-mediated colitis.
Colonoscopy
Immune checkpoint inhibitor
Immune-mediated colitis
Immune-related adverse events
Transabdominal ultrasonography
Journal
Intestinal research
ISSN: 1598-9100
Titre abrégé: Intest Res
Pays: Korea (South)
ID NLM: 101572802
Informations de publication
Date de publication:
Jan 2023
Jan 2023
Historique:
received:
03
12
2021
accepted:
06
06
2022
pubmed:
22
7
2022
medline:
22
7
2022
entrez:
21
7
2022
Statut:
ppublish
Résumé
The usefulness of ultrasonography (US) in diseases of the gastrointestinal tract has been reported recently. This prospective study aimed to determine the features of US findings in immune-mediated colitis (IMC), an adverse event induced by immune checkpoint inhibitor, and examine the correlation between US findings, colonoscopy (CS) findings, and severity of colitis. We studied patients examined using CS and US upon suspicion of IMC in Hokkaido University Hospital between April 2018 and February 2021. Endoscopic findings of IMC were assessed using the Ulcerative Colitis Endoscopic Index of Severity (UCEIS). The severity of US findings in IMC was evaluated using US grade, which is the ultrasonographic grading scale in ulcerative colitis. Bowel wall thickness and the intensity of the color Doppler signal were also analyzed. Severity of colitis was evaluated using Common Terminology Criteria for Adverse Events (CTCAE) grade version 5. Fourteen patients with IMC were enrolled. The US findings were bowel wall thickening, loss of stratification, ulceration and increased blood flow signal. The US grade was moderately correlated with the UCEIS (r=0.687, p=0.009) and CTCAE grade (r=0.628, p=0.035). Bowel wall thickness and UCEIS (r=0.628, p=0.020), as well as color Doppler signal grade and CTCAE grade (r=0.724, p=0.008), were significantly correlated. US findings in IMC were mainly similar to those of ulcerative colitis, but there were some findings that were characteristic only of IMC. Significant correlation was found between US findings, CS findings, and severity of colitis. Hence, US could be useful for the evaluation of IMC.
Sections du résumé
BACKGROUND/AIMS
OBJECTIVE
The usefulness of ultrasonography (US) in diseases of the gastrointestinal tract has been reported recently. This prospective study aimed to determine the features of US findings in immune-mediated colitis (IMC), an adverse event induced by immune checkpoint inhibitor, and examine the correlation between US findings, colonoscopy (CS) findings, and severity of colitis.
METHODS
METHODS
We studied patients examined using CS and US upon suspicion of IMC in Hokkaido University Hospital between April 2018 and February 2021. Endoscopic findings of IMC were assessed using the Ulcerative Colitis Endoscopic Index of Severity (UCEIS). The severity of US findings in IMC was evaluated using US grade, which is the ultrasonographic grading scale in ulcerative colitis. Bowel wall thickness and the intensity of the color Doppler signal were also analyzed. Severity of colitis was evaluated using Common Terminology Criteria for Adverse Events (CTCAE) grade version 5.
RESULTS
RESULTS
Fourteen patients with IMC were enrolled. The US findings were bowel wall thickening, loss of stratification, ulceration and increased blood flow signal. The US grade was moderately correlated with the UCEIS (r=0.687, p=0.009) and CTCAE grade (r=0.628, p=0.035). Bowel wall thickness and UCEIS (r=0.628, p=0.020), as well as color Doppler signal grade and CTCAE grade (r=0.724, p=0.008), were significantly correlated.
CONCLUSIONS
CONCLUSIONS
US findings in IMC were mainly similar to those of ulcerative colitis, but there were some findings that were characteristic only of IMC. Significant correlation was found between US findings, CS findings, and severity of colitis. Hence, US could be useful for the evaluation of IMC.
Identifiants
pubmed: 35860848
pii: ir.2021.00166
doi: 10.5217/ir.2021.00166
pmc: PMC9911272
doi:
Types de publication
Journal Article
Langues
eng
Pagination
126-136Subventions
Organisme : Hokkaido University Hospital
Références
Aliment Pharmacol Ther. 2017 Mar;45(6):801-813
pubmed: 28112419
Lancet. 2016 Apr 9;387(10027):1540-1550
pubmed: 26712084
N Engl J Med. 2010 Aug 19;363(8):711-23
pubmed: 20525992
N Engl J Med. 2015 Jun 25;372(26):2509-20
pubmed: 26028255
J Clin Oncol. 2018 Jun 10;36(17):1714-1768
pubmed: 29442540
J Crohns Colitis. 2014 Sep;8(9):1079-87
pubmed: 24613399
N Engl J Med. 2015 Oct 22;373(17):1627-39
pubmed: 26412456
Gut. 2018 Nov;67(11):2056-2067
pubmed: 30131322
J Clin Oncol. 2015 May 1;33(13):1430-7
pubmed: 25452452
Aliment Pharmacol Ther. 2019 Jun;49(12):1474-1483
pubmed: 31035308
ESMO Open. 2018 Jan 13;3(1):e000278
pubmed: 29387476
Clin Gastroenterol Hepatol. 2017 Sep;15(9):A35-A36
pubmed: 28351793
Oncoimmunology. 2016 Feb 18;5(6):e1128611
pubmed: 27471608
J Gastroenterol. 2019 Jun;54(6):521-529
pubmed: 30519747
Dis Colon Rectum. 1996 Nov;39(11):1308-14
pubmed: 8918445
Br J Cancer. 2020 Jul;123(2):207-215
pubmed: 32418993
Dig Liver Dis. 2008 Nov;40(11):860-6
pubmed: 18583205
J Crohns Colitis. 2016 Apr;10(4):395-401
pubmed: 26783344
Gastroenterology. 2013 Nov;145(5):987-95
pubmed: 23891974
J Immunother Cancer. 2018 Sep 25;6(1):95
pubmed: 30253811
Gastroenterology. 1976 Mar;70(3):439-44
pubmed: 1248701
Inflamm Bowel Dis. 2016 May;22(5):1168-83
pubmed: 26958988
Gut. 2002 Apr;50(4):490-5
pubmed: 11889068
N Engl J Med. 2015 Jan 22;372(4):320-30
pubmed: 25399552
Gastroenterology. 2009 Jul;137(1):43-52
pubmed: 19422826
Lancet Oncol. 2015 May;16(5):522-30
pubmed: 25840693
J Clin Oncol. 2019 Oct 20;37(30):2738-2745
pubmed: 31163011
Gastroenterology. 2002 Dec;123(6):1786-92
pubmed: 12454834
Aliment Pharmacol Ther. 2003 Nov 15;18(10):1009-16
pubmed: 14616167
Inflamm Bowel Dis. 2018 Jul 12;24(8):1695-1705
pubmed: 29718308
Dig Dis. 2009;27(4):482-93
pubmed: 19897964
Am Soc Clin Oncol Educ Book. 2015;:76-83
pubmed: 25993145
World J Gastrointest Pathophysiol. 2019 Sep 10;10(2):17-28
pubmed: 31559106
J Clin Oncol. 2012 Jul 20;30(21):2691-7
pubmed: 22614989
Abdom Imaging. 2009 Mar-Apr;34(2):141-8
pubmed: 18214582
Clin Transplant. 2015 Aug;29(8):697-704
pubmed: 26009803
Eur J Cancer. 2017 Nov;86:248-256
pubmed: 29055840
Nature. 2014 Nov 27;515(7528):558-62
pubmed: 25428503
N Engl J Med. 2015 Jul 9;373(2):123-35
pubmed: 26028407
Intern Med. 2018 May 1;57(9):1269-1272
pubmed: 29279482
Gut. 2004 Nov;53(11):1652-7
pubmed: 15479688
Abdom Imaging. 2008 Sep-Oct;33(5):589-97
pubmed: 18172707
Clin Gastroenterol Hepatol. 2021 May;19(5):908-921.e6
pubmed: 32777549
Ann Oncol. 2017 Jul 1;28(suppl_4):iv119-iv142
pubmed: 28881921
J Ultrasound Med. 2021 Dec;40(12):2595-2605
pubmed: 33595133
N Engl J Med. 2015 Jan 22;372(4):311-9
pubmed: 25482239
BMC Gastroenterol. 2018 Aug 31;18(1):135
pubmed: 30170560