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Multispectral optoacoustic tomography shows promise for evaluating Crohn’s disease activity
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Evaluating hemoglobin levels in the intestinal wall using multispectral optoacoustic tomography shows potential for differentiating between active disease and remission in patients with Crohn’s disease, according to a research letter published in the New England Journal of Medicine.
“Multispectral optoacoustic tomography (MSOT) is a new imaging technique that permits the noninvasive quantification of hemoglobin-dependent tissue perfusion and oxygenation as surrogates of inflammation,” Maximilian J. Waldner, MD, of the University of Erlangen-Nuremberg, Germany, and colleagues wrote. “This approach uses the excitation of short-pulsed laser light with near-infrared wavelengths to induce the photoacoustic effect in targeted tissues, which results in detectable sound waves induced by thermoelastic expansion.”
Waldner and colleagues conducted a cross-sectional study in which they used the MSOT Acuity Echo (iThera Medical) to perform transabdominal evaluation of intestinal inflammation in 108 patients with Crohn’s disease at a single center. Then they compared MSOT measurements between patients with active vs. nonactive disease as determined by clinical, endoscopic and histologic criteria.
They found significant differences in all MSOT values — except oxygen saturation — between patients with active vs. nonactive Crohn’s disease in an analysis of 44 patients using endoscopy as the reference standard (P .001). Further, they found similar results in an analysis of 42 patients using histology as the reference standard, but did not find similar results in an analysis of 86 patients using clinical scoring as the reference standard.
The results also suggested that patients in endoscopic remission and those with low-grade active disease showed significant differences in single-wavelength measurements at 760 nm (P = .02) and in spectrally unmixed total hemoglobin (P = .03).
“In conclusion, this preliminary study suggests that MSOT-based assessment of hemoglobin levels in the intestinal wall has the potential to be used to distinguish active disease from remission in patients with Crohn’s disease without the need for more invasive procedures,” the investigators concluded, adding that “further study is needed.” – by Adam Leitenberger
Disclosures: Some of the researchers report financial relationships with iThera Medical. Please see the full study for a list of all other researchers’ relevant financial disclosures.
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