A Nomogram Based on Laboratory Data, Inflammatory Bowel Disease Questionnaire and CT Enterography for Activity Evaluation in Crohn's Disease.

Abstract

Background: Accurately assessing the activity of Crohn's disease (CD) is crucial for determining prognosis and guiding treatment strategies for CD patients.

Objective: This study aimed to develop and validate a nomogram for assessing CD activity.

Methods: The semi-automatic segmentation method and PyRadiomics software were employed to segment and extract radiomics features from the spectral CT enterography images of lesions in 107 CD patients. The radiomic score (rad-score) was calculated using the radiomic signature formula. Multivariate logistic regression analysis identified the independent risk factors of erythrocyte sedimentation rate, fecal calprotectin, and Inflammatory Bowel Disease Questionnaire (IBDQ), and a nomogram was constructed in combination with rad-score. The nomogram underwent evaluation and testing in the training set (n = 84) and validation set (n = 23), respectively.

Results: The discrimination performance of the combined (AUC 0.877) was marginally superior to that of IBDQ + clinical (AUC 0.854). However, there was no significant difference in AUC between the two models in the validation set (P = 0.206). IBDQ + clinical outperformed clinical (AUC 0.808), clinical outperformed IBDQ (AUC 0.746), and IBDQ outperformed radiomic signature (AUC 0.688). Significant differences in AUC were observed between the two models (radiomic signature vs clinical, P = 0.026; radiomic signature vs IBDQ + clinical, P = 0.011; radiomic signature vs combined, P = 0.008; in the validation set).

Conclusion: The nomogram, combined with laboratory data, IBDQ and rad-score, presents an accurate and reliable method for assessing CD activity.

Clinical impact: The nomogram enhances the potential for personalized treatment plans and better disease management, making it a valuable tool for clinical practice.