Hameed Maira, Plumb Andrew A, Chowdhury Kashfia, Ahmed Norin, Rahman Safi, Bhatnagar Gauraang, Thomson Elen, Mohsin Maryam, Holmes Jude, Halligan Steve, Taylor Stuart A
Department of Radiology, University College London Hospitals, London, NW1 2BU, UK.
Centre for Medical Imaging, University College London, London, W1W 7TS, UK.
Insights Imaging. 2025 May 27;16(1):111. doi: 10.1186/s13244-025-01978-8.
Motility magnetic resonance imaging (mMRI) is a potential marker of disease activity of small bowel Crohn's disease (SBCD), but there is limited data on its reproducibility. We assessed inter- and intra-observer agreement of small bowel motility as part of a prospective multicentre trial investigating whether mMRI can predict longer-term response to biologic therapy in active, non-stricturing SB-CD (MOTILITY Trial).
297 segmental small bowel motility scores from 104 SBCD patients (mean age 38.9 years, 43 female) recruited to the MOTILITY trial were measured independently by two radiologists experienced in mMRI, using GIQuant software. Twenty-six datasets were re-read by both radiologists to test intra-observer variability after a washout period of at least 6 weeks. Five gastrointestinal radiologists inexperienced in mMRI derived 66 segmental motility scores from the same 30 randomly selected patients. Agreement was quantified using the intra-class correlation coefficient (ICC).
There was moderate agreement for mMRI-derived segmental small bowel motility measurements for both mMRI-experienced and inexperienced radiologists (ICC 0.59 (95% CI: 0.51, 0.66) and 0.70 (95% CI: 0.61, 0.78), respectively). Agreement remained moderate to good, combining the experienced trial MRI reader measurements with those of the five inexperienced radiologists (ICC 0.69 (95% CI: 0.61, 0.78). Intra-observer agreement for the two mMRI experienced radiologists was (0.71 (95% CI: 0.44, 0.86) and 0.70 (95% CI: 0.44, 0.86)).
There is moderate to good interobserver agreement for mMRI measurements of segmental small bowel motility for both experienced and inexperienced radiologists.
Study findings support the continuing clinical translation of motility MRI as a reproducible biomarker of disease activity and treatment response in Crohn's disease.
Motility MRI is a novel biomarker of small bowel Crohn's disease activity. Currently, limited data on intra- and inter-observer variability exists. Motility MRI shows moderate to good inter- and intra-observer agreement. Intraclass correlation was 0.59-0.71 for experienced and inexperienced radiologists. Motility MRI is reproducible, supporting its utility as a biomarker of disease activity.
动力磁共振成像（mMRI）是小肠克罗恩病（SBCD）疾病活动的一个潜在标志物，但关于其可重复性的数据有限。作为一项前瞻性多中心试验的一部分，我们评估了小肠动力的观察者间和观察者内一致性，该试验旨在研究mMRI是否能够预测活动性、非狭窄性小肠克罗恩病（MOTILITY试验）对生物治疗的长期反应。
招募到MOTILITY试验中的104例SBCD患者（平均年龄38.9岁，43例女性）的297个节段性小肠动力评分，由两名有mMRI经验的放射科医生使用GIQuant软件独立测量。在至少6周的洗脱期后，两名放射科医生对26个数据集进行重新阅读，以测试观察者内变异性。五名无mMRI经验的胃肠放射科医生从相同的30例随机选择的患者中得出66个节段性动力评分。使用组内相关系数（ICC）对一致性进行量化。
对于有mMRI经验和无经验的放射科医生，mMRI得出的节段性小肠动力测量结果均有中度一致性（ICC分别为0.59（95%CI：0.51，0.66）和0.70（95%CI：0.61，0.78））。将有经验的试验MRI阅片者的测量结果与五名无经验的放射科医生的测量结果相结合，一致性仍为中度至良好（ICC 0.69（95%CI：0.61，0.78））。两名有mMRI经验的放射科医生的观察者内一致性为（0.71（95%CI：0.44，0.86）和0.70（95%CI：0.44，0.86））。
对于有经验和无经验的放射科医生，mMRI测量节段性小肠动力的观察者间一致性为中度至良好。
研究结果支持将动力MRI作为克罗恩病疾病活动和治疗反应的可重复生物标志物继续进行临床转化。
动力MRI是小肠克罗恩病活动的一种新型生物标志物。目前，关于观察者内和观察者间变异性的数据有限。动力MRI显示观察者间和观察者内一致性为中度至良好。有经验和无经验的放射科医生的组内相关系数为0.59 - 0.71。动力MRI具有可重复性，支持其作为疾病活动生物标志物的效用。
