Colonoscopy is the standard intestinal examination for diagnosing and monitoring Crohn's disease. It is a stressful procedure in which a flexible tube fitted with a camera is passed into the large intestine. MRI scans are therefore often used as an alternative to monitor the course of the disease and how it is responding to treatment. TU Delft is joining six European partners from the academic world to develop an objective, quantitative method for assessing these MRI scans. The EU has awarded a grant of three million euros to this project, which goes by the name of VIGOR++. The researchers expect that this new method will enable doctors to more accurately determine the activity level of the disease over time and that it may lead to a reduction in the number of colonoscopies.
Autoimmune disease
Chronic diseases of the intestines are among the most widespread medical problems in the Western world. Over one million Europeans suffer from such a disease; in 700,000 cases it is diagnosed as an autoimmune condition called Crohn's disease. This chronic condition is characterised by alternating periods of increased and reduced disease activity. It is therefore important to regularly assess the stage of the disease in order to adjust the treatment accordingly.
Stressful
In order to evaluate Crohn's disease, doctors ask their patients questions about their condition and carry out a colonoscopy, during which samples of tissue are removed (biopsy). However, the conclusions drawn from a patient's answers are not always sufficiently reliable. In addition, patients experience this procedure as highly stressful, since the large intestine first has to be cleared using laxatives and a flexible tube fitted with a camera is passed into the large intestine through the rectum. This makes the method less suitable for regular application for the purposes of monitoring.
MRI scans are therefore being used more frequently to assess the disease's level of activity. "The assessment of the MRI scans is not very objective at present," Jaap Stoker, Professor of Radiology at the University of Amsterdam Academic Medical Centre (AMC), points out. "Objective MRI assessment techniques will enable us to use MRI to better monitor the disease activity for Crohn's disease. This may among others have a beneficial effect on the side effects and costs resulting from long-term medicine use to treat the disease."
MRI
TU Delft is about to join forces with six European partners to develop a new assessment method in a project entitled VIGOR++. Researcher and project leader Dr Frans Vos, who works at TU Delft and the AMC explains: "We are going to investigate objective methods to quantitatively determine the severity of the disease using MRI scans. MRI images make it possible to measure the thickness of the intestinal wall, the degree of vascularization and to distinguish the various layers of the intestine. These are all indicators of the extent to which Crohn's disease is active. All that is required is the intravenous administration of a contrast medium." He continues "It's essentially an ICT project. After all, the basis is statistical pattern recognition. For that purpose one of the first things we need to do is analyse large quantities of MRI images."
Maximum score
Dr Vos is justifiably proud of the project. "We were awarded the maximum score possible in the EU assessment of our research proposal. In recent decades only one other EU project has received such a high score. This ensured that we were selected ahead of around 480 other proposals.
The consortium includes research groups which are specialised in radiology, medical image analysis, modelling, scientific visualisation methods, gastroenterology and commercial application. TU Delft has taken on a coordinating role in the consortium and is working together on this project with the AMC, University College London Hospitals, ETH Zurich, the Zuse Institute in Berlin and the British companies Biotroncis3D and Vodera.
The EU has made a grant of three million euros available for the VIGOR++ project (as part of its 7th Framework Programme). The total cost of the project will be four million euros.
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