Furthermore, a meta-analysis based on 290 patients from 6 studies showed sensitivity and specificity in detecting active small bowel Crohn disease was 85.8% and 83.6%, respectively, with the AUC of 0.898 [14]. CTE imaging features of active Crohn disease inflammation are very similar to those reported for MRE and include mural (eg, wall thickening and hyperenhancement) and perienteric (eg, engorged vasa recta, fibrofatty proliferation, adenopathy) features of disease [15]. A study comparing the performance of different CTE and MRE imaging features compared with histologic reference showed that mural features of disease (wall thickening and hyperenhancement) performed better than perienteric features in evaluating activity and may be more reliable features in cases in which some but not all features of activity are present [16]. Although relative radiation levels are beyond the purview of this discussion, they are listed in the tables at the beginning of the document and may be considered by the requesting physician particularly in the setting of disease surveillance and therapy monitoring in children. For additional information, please see the Relative Radiation Level Information section at the end of this document. Crohn Disease-Child FDG-PET/CT Skull Base to Mid-Thigh Combining metabolic information from FDG-PET with anatomic CT imaging shows potential to further diagnostic accuracy in children. A meta-analysis of 7 studies with a total of 219 patients (3 studies with 93 patients were pediatric focused) on a per segment basis showed sensitivity was 85%, specificity 87%, and area under the receiver operating characteristic curve was 0.93. PET/CT may be particularly helpful to assess the level of active inflammation from fibrosis [18]. One pediatric study with 23 patients showed a sensitivity and specificity for the terminal ileum of 89% and 75%, respectively [19]. At the present time, however, there is a paucity of larger clinical studies published, particularly in children.
Crohn Disease Child. Furthermore, a meta-analysis based on 290 patients from 6 studies showed sensitivity and specificity in detecting active small bowel Crohn disease was 85.8% and 83.6%, respectively, with the AUC of 0.898 [14]. CTE imaging features of active Crohn disease inflammation are very similar to those reported for MRE and include mural (eg, wall thickening and hyperenhancement) and perienteric (eg, engorged vasa recta, fibrofatty proliferation, adenopathy) features of disease [15]. A study comparing the performance of different CTE and MRE imaging features compared with histologic reference showed that mural features of disease (wall thickening and hyperenhancement) performed better than perienteric features in evaluating activity and may be more reliable features in cases in which some but not all features of activity are present [16]. Although relative radiation levels are beyond the purview of this discussion, they are listed in the tables at the beginning of the document and may be considered by the requesting physician particularly in the setting of disease surveillance and therapy monitoring in children. For additional information, please see the Relative Radiation Level Information section at the end of this document. Crohn Disease-Child FDG-PET/CT Skull Base to Mid-Thigh Combining metabolic information from FDG-PET with anatomic CT imaging shows potential to further diagnostic accuracy in children. A meta-analysis of 7 studies with a total of 219 patients (3 studies with 93 patients were pediatric focused) on a per segment basis showed sensitivity was 85%, specificity 87%, and area under the receiver operating characteristic curve was 0.93. PET/CT may be particularly helpful to assess the level of active inflammation from fibrosis [18]. One pediatric study with 23 patients showed a sensitivity and specificity for the terminal ileum of 89% and 75%, respectively [19]. At the present time, however, there is a paucity of larger clinical studies published, particularly in children.