P217 The use of imaging techniques in the diagnosis and management of Crohn's Disease: Results of a national survey (Raymond study) aimed at Spanish gastroenterologists and radiologists
A. Gutiérrez*1, I. Ordás2, I. Marín-Jiménez3, J. Hinojosa4, J. Rimola5, A. Torregrosa6
1Hospital General Universitary Alicante, Gastroenterology, Alicante, Spain, 2Hospital Clinic of Barcelona, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Gastroenterology, Barcelona, Spain, 3Hospital General Universitario "Gregorio Marañón", Gastroenterology Unit, Madrid, Spain, 4Hospital de Manises, IBD unit, Manises, Spain, 5Hospital Clinic of Barcelona, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Radiology, Barcelona, Spain, 6Hospital La Fe, Radiology Department, Valencia, Spain
Radiological imaging plays a major role in diagnosis of both luminal disease and extra-enteric complications in CD.
1. To describe the perception of the utility and real use of imaging techniques in the diagnosis and management of patients with CD among a sample of Spanish gastroenterologists(G) and radiologists(R). 2. To establish the degree of theoretical and practical agreement regarding the use of imaging techniques in both groups of professionals.
Descriptive study based on information obtained from a survey('RAYMOND' study) aimed at Spanish G and R. It included questions on the imaging and endoscopy techniques, their real use and their limitations in CD.
Between May and July 2013, 324 professionals (69.3% G and 30.7% R) answered the survey. Of these, 9.5% of the R were specialised particularly in chronic IBD and 47.4% in abdominal imaging. Sixty eight percent of the G were specialized in CD. For the vast majority of G (99%), endoscopy is the most appropriate examination for the diagnosis of luminal CD while barium follow-through(BFT) is used by only 8%. With respect to imaging techniques, among all groups of professionals, MRI is considered the most appropriate technique, followed by CT, ultrasonography(US) and lastly barium follow-through in all clinical scenarios. Routine use of the Patency capsule is 15% higher among G working in centres with a larger volume of patients (> 300 beds). Among the limiting factors for the use of the different techniques are, in first , waiting lists for MRI (28%), unavailability for capsule endoscopy (21%), or lack of experience for US (37%). With respect to the degree of theoretical and practical agreement between G and R, 77 pairs of specialists from the same centre were matched up. The % of ponderated agreement in the use of imaging techniques for location and extent of active CD between G and R in the diagnosis of luminal CD was 64% for MRI, 73.6% for CT, 87.5% for US and 85% for BFT, and 54.6%, 61.6%, 70.8% and 95.7%, respectively, for detection of intra-abdominal fistulas and/or abscesses.
Among the imaging techniques for the diagnosis and management of CD, endoscopy and MRI are the most highly considered and widely used by G and R, while BFT is used only by a minority. The percentage of agreement between G and R is high in all scenarios for the different imaging techniques, both theoretically and in real use.