Crohns Disease Assessment Improvement

Crohns Disease is heading towards having improved ways to assess improvement.

There are 2 researchers, Robiël Naziroglu and Frans Vos, who have developed a new method for improving the assessment of MRI images while reviewing patients with Crohn’s Disease.  They anticipate that in time, this will enable a more specific monitoring and treatment of crohns. Naziroglu intends to take his doctorate on this subject at TU Delft on Monday 21 November, 2016.

Crohn’s disease is known to be a chronic inflammatory disease of the gut that is found in many diverse people in the Western world.  The disease is known to have periods of time when the condition alternates between active and less active phases.

‘This means that it is crucial to determine the activity level as well as the presence of the disease. Crohns Disease activity can be divided into different score levels, and every score level has a different treatment plan. This so-called grading of the Crohn’s disease activity is therefore important for monitoring the progression of the disease and for determining the treatment strategy and whether it is working,’ says Naziroglu.

Naziroglu continues ….. ‘Ideally, such a score for disease activity would be objective, reproducible, quantitative, non-invasive and complete. Unfortunately, however, less than perfect scoring systems are still being used at present, based on MRI and endoscopy, among other things. The aim of the VIGOR++ project, of which my research formed a part, was to develop a better scoring system by looking at both manually and automatically obtained MRI measurements.’

He says that this has proved to be a challenge.

‘That’s because the intestines are relatively complex, including in a geometric sense.’, he says. ‘The segmentation (division) of the intestinal wall is a crucial step in being able to identify the disease automatically from Crohn’s activity on MRI images, but it’s therefore tricky. So I developed an algorithm that is able to handle the complexity of the intestines well, by using prior knowledge of the content of the intestines and of knowledge of the surrounding anatomy.’

Crohn’s Disease Testing

Naziroglu’s method was developed using images from 27 patients with Crohn’s disease and subsequently tested on 120 patients.

‘Our semi-automatic method allows us to obtain very reproducible outlines and thickness measurements of actively diseased parts of the . With the VIGOR++ system, a method was also developed to score and validate disease activity using endoscopy. As well as this, the system was compared with other state-of-the-art MRI scoring systems and was shown to be performing well: the reproducibility proved to be significantly higher.’

Hospital Involvement in Crohns Disease Testing

Naziroglu worked closely with doctors for his research. This included the Academic Medical Center (AMC) in Amsterdam.

It is still unclear as to the extent to which, and how often, his method will be used in the medical world.

‘The method will certainly have to be tested further and developed before it can be used in practice on a large scale, and adjustments will need to be made, but I think that this new method is very promising,’ he says.

Information is provided by Delft University of Technology