Table 3 Intestinal fibrosis imaging—pros/cons with respects to the gold standard (endoscopy)
Intestinal fibrosis imaging | ||
|---|---|---|
US-SE/SWE | PROs | Readily available, low cost, lack of ionizing radiation |
CONs | Operator dependent, dependent on patient habitus | |
CEUS | PROs | Higher accuracy, quantitative |
CONs | Ineffective in case of active inflammation, use of contrast agent | |
CE-CTa | PROs | High accuracy, readily available, high spatial resolution, fast |
CONs | Use of contrast agents, use of ionizing radiation | |
CE-MRI | PROs | High accuracy, no ionizing radiation, higher soft tissue contrast, high sensitivity in early stages |
CONs | Use of contrast agents, low sensitivity in late stages, high cost, time consuming | |
IVIM/DWI-MRI | PROs | High sensitivity/specificity/accuracy, no use of contrast agents, quantitative |
CONs | Lower effectiveness in case of active inflammation, high cost, time consuming | |
MT-MRIb | PROs | Quantitative, no ionizing radiation, unaffected by active inflammation, no use of contrast agents |
CONs | High cost, time consuming | |
DCE-MRI | PROs | Distinguishes active/inactive inflammation, quantitative |
CONs | Use of contrast agent, high cost, time consuming | |
18-FDG-PET-CT | PROs | Reduced false positive rate |
CONs | Use of ionizing radiation, sequential (not concurrent) image acquisition, use of contrast agent | |
18-FDG-PET-MRI | PROs | Concurrent image acquisition, improved accuracy compared to PET and MRI alone, higher accuracy than 18-FDG-PET-CT, Higher signal-to-noise ratio, higher contrast-to-noise ratio, useful in distinguishing inflammatory/fibrotic strictures |
CONs | Use of contrast agent | |