ECCO Grant Study Synopsis: Ferdinando D’Amico
Ferdinando D’Amico, ECCO Grant Awardee
Comparative accuracy of TransPerineal UltraSound (TPUS) versus Magnetic Resonance Imaging (MRI) for the assessment of perianal fistulae in patients with Crohn’s Disease: a prospective observational longitudinal cohort study
© Ferdinando D’Amico
Background & aim of research
Magnetic resonance imaging (MRI) is the first-line imaging modality for monitoring of perianal disease in patients with Crohn’s Disease (CD). However, its use depends on local availability, costs and expertise. Few studies are available on the role of transperineal ultrasound (TPUS). Performing MRI alone in all patients would impose a substantial expense on the health service and would represent a limitation for the many patients who cannot tolerate the procedure (e.g. owing to claustrophobia). For this reason, we urgently need a painless, non-invasive, cost-effective and widely available modality to assess perianal disease and predict disease outcomes. In this observational prospective study, we investigate the accuracy of TPUS versus pelvic MRI in the diagnosis and monitoring of medical and surgical treatment of perianal fistulae in CD patients.
Methodology/experiments that will be used
Adult patients with a confirmed diagnosis of CD and perianal fistulae will be enrolled by the Gastroenterology Department of the San Raffaele Hospital. Patients will undergo both TPUS and pelvic MRI at baseline. After radiological and ultrasound evaluation, they will be treated according to international ECCO Guidelines. Finally, patients will undergo both TPUS and pelvic MRI after 12 months. The primary endpoints of the study will be the incidence of perianal fistulae at baseline and the rate of fistula closure at 12 months as assessed on both TPUS and MRI.
Anticipated main impact
TPUS and MRI are standard procedures in and are both recommended by international guidelines. Ultrasound is generally preferred as it is faster, less expensive and better tolerated by patients. If we demonstrate that TPUS has an accuracy comparable to that of MRI, TPUS could become the reference tool for evaluating CD patients with perianal disease, significantly reducing healthcare costs.
We assume that the study will be concluded by November 2023.