The use of computed tomography enterography (CTE) imaging to investigate patients with suspected or established Crohn’s disease would result in changes being made to around half of management plans.

• Edward Loftus and colleagues say that the management plan changes observed during the study, namely the exclusion of active CD and medication alterations, arose from an increased level of diagnostic confidence (LOC) among physicians using CTE.
• These findings demonstrate that CTE, a contrast-based small intestine imaging technique, “allows clinicians to make accurate assessments of small bowel disease activity and complications based on objective data, leading to more appropriate management plans.”
• Loftus and team reported in the journal Inflammatory Bowel Diseases that they asked the treating physicians of 273 patients with established (n=145) or suspected (n=128) CD to complete a pre- and post-CTE questionnaire indicating their proposed clinical management plan and LOC (on a 5-point scale) when diagnosing active disease and complications, such as fistulas or abscesses.

• After analyzing the completed questionnaires, the researchers found that patients’ CTE findings led physicians to alter the management plans of 139 (51.0%) patients.
• Of these, 70 (48.3%) had established CD and 69 (54.9%) had suspected CD.
• The team highlighted that the most frequent changes to the management of those with established CD was a change in medication (24.1%).
• The exclusion of CD as a diagnosis was the most common change among patients with suspected CD (35.9%).
• Furthermore, an increase in physician LOC by 2 or more points after CTE occurred in 77.7% of all cases.
• These data provide additional support favoring the routine use of cross-sectional enterography in diagnostic and management algorithms for patients with CD.

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