Monitoring of Pediatric Inflammatory Bowel Diseases Using Multispectral Optoacoustic Tomography

Study Overview
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Brief Summary
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In this clinical trial, the intestinal wall of pediatric patients with Crohns disease and Ulcerative Colitis will be assessed with multispectral optoacoustic tomography (MSOT) to characterize the optoacoustic signal of the intestinal wall and to monitor disease activity. The goal of this clinical trial is to compare the optoacoustic signal in the intestinal wall of children with inflammatory bowel diseases. The main questions it aims to answer are: How does the optoacoustic signal in children with inflammatory bowel diseases change over time? How does the optoacoustic signal in children with inflammatory bowel diseases change when they receive therapy? Participants will be examined with multispectral optoacoustic tomography.

Detailed Description
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In this study, the disease activity of children and adolescents with inflammatory bowel disease (IBD) will be assessed non-invasively by multispectral optoacoustic tomography (MSOT). IBDs play an important role in pediatric and adolescent medicine. The most common entities in the IBS group are Crohn's disease (CD) and ulcerative colitis (UC). Patients with CD develop chronic intermittent transmural inflammation of the gastrointestinal (GI) tract. Symptoms include diarrhea, hematochezia, abdominal pain, and malnutrition. Complications of the disease include fistula formation, perforations, and bleeding.The basis for many clinical decisions is the detection of disease activity.There are limitations to previous imaging methods for routine monitoring that are particularly relevant in pediatric and adolescent medicine.The use of contrast media, sedation, and invasive procedures are a burden for pediatric patients*.Multispectral optoacoustic tomography (MSOT) offers a radiation-free and noninvasive alternative for detecting disease activity. Quantitative assessment of hemoglobin signal in the bowel wall of patients with CD could previously be correlated with endoscopically detected disease activity. The aim of this study is to evaluate whether MSOT also allows monitoring of chronic inflammatory diseases in children. For this purpose, children in different stages of disease who regularly receive intravenous therapeutic administrations of biologics (e.g. infliximab) in our hospital will be examined. The investigators think that by means of MSOT different stages and courses of the diseases could be measured non-invasively and thus invasive measures in children could be reduced.

Official Title
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Non-invasive Monitoring of Disease Activity in Pediatric Inflammatory Bowel Diseases Using Multispectral Optoacoustic Tomography

Conditions
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Crohn Disease, Ulcerative Colitis, Inflammatory Bowel Diseases

Intervention / Treatment
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* Diagnostic Test: Multispectral Optoacoustic Tomography


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Existing diagnosis of CD or UC, or suspected CD or UC at initial diagnosis. Age 2 - 18 years Written declaration of consent from parents / legal guardians Exclusion Criteria: Pregnancy Nursing mothers Cardiopulmonary unstable patients*: Need for continuous cardiopulmonary monitoring Tattoo in the area of the examination field Subcutaneous fat > 3 cm

Ages Eligible for Study
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Minimum Age: 2 Years
Maximum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Crohns Disease<br>Patients with Crohns Disease | Diagnostic Test: Multispectral Optoacoustic Tomography<br>* In MSOT, laser light is emitted into the target tissue via a handheld probe. Thermoelastic expansion of various molecules in the target area generates ultrasound waves that are detected by the transducer. The detected signals are reconstructed into images using algorithms. Spectral analysis of the optoacoustic signal at different wavelengths in the near-infrared range can detect individual chromophores, such as oxygenated and deoxygenated hemoglobin.<br>|
| Ulcerative Colitis<br>Patients with Ulcerative Colitis | Diagnostic Test: Multispectral Optoacoustic Tomography<br>* In MSOT, laser light is emitted into the target tissue via a handheld probe. Thermoelastic expansion of various molecules in the target area generates ultrasound waves that are detected by the transducer. The detected signals are reconstructed into images using algorithms. Spectral analysis of the optoacoustic signal at different wavelengths in the near-infrared range can detect individual chromophores, such as oxygenated and deoxygenated hemoglobin.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| MSOT signal for hemoglobin in the intestinal wall of participants | Longitudinal analysis of MSOT signal for oxygenated and deoxygenated hemoglobin in the intestinal wall of children and adolescents with CD and UC. | 6 - 12 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Quantitative comparison of the signal of oxygenated and deoxygenated hemoglobin measured by MSOT in inflamed and non-inflamed intestinal wall sections of children and adolescents with CD and UC. | Quantitative comparison of the signal of oxygenated and deoxygenated hemoglobin measured by MSOT in inflamed and non-inflamed intestinal wall sections of children and adolescents with CD and UC. | 6 - 12 months | 
| Quantitative comparison of oxygenated and deoxygenated hemoglobin signal measured by MSOT in different intestinal wall sections of children and adolescents with CD and UC. | Quantitative comparison of oxygenated and deoxygenated hemoglobin signal measured by MSOT in different intestinal wall sections of children and adolescents with CD and UC. | 6 - 12 months | 
| -Quantitative comparison of the quantitative fraction of fibrosis/collagen signal determined by MSOT in intestinal walls of children with IBD of different entities (CD and UC) | -Quantitative comparison of the quantitative fraction of fibrosis/collagen signal determined by MSOT in intestinal walls of children with IBD of different entities (CD and UC) | 6 - 12 months | 
| Quantitative amount of single wavelength signal in a.u. | single wavelength signals in the intestinal wall of children with different entities of IBD (CD vs. UC) derived by MSOT in arbitrary units (a.u.) | 6 - 12 months | 
| Optoacoustic spectrum in a.u | Optoacoustic spectrum in the intestinal wall of children with different entities of IBD (CD vs. UC) derived by MSOT in arbitrary units (a.u.) | 6 - 12 months | 
| Endoscopic extent of inflammation (if applicable) | Assessment of inflammation in endoscopies within different entities of IBD (CD vs. UC) | 6 - 12 months | 
| Histological extent of inflammation and fibrosis (if applicable) | Assessment of inflammation and fibrosis in histological samples from biopsies within different entities of IBD (CD vs. UC) | 6 - 12 months | 
| Clinical evaluation | Assessement of clinical disease status by PCDAI or PUCAI according to the CED within different entities of IBD (CD vs. UC) | 6 - 12 months | 
| Ultrasound | Assessment of disease status by ultrasound within different entities of IBD (CD vs. UC) | 6 - 12 months | 
| Laboratory parameters (blood - c-reactive protein (CrP)) (if applicable) | Assessment of disease status by laboratory parameters (CrP) within different entities of IBD (CD vs. UC) | 6 - 12 months | 
| Laboratory parameters (stool - Calprotectin) (if applicable) | Assessment of disease status by laboratory parameters (Calprotectin) within different entities of IBD (CD vs. UC) | 6 - 12 months | 
| MRI (if applicable) | Assessment of disease status by MRI within different entities of IBD (CD vs. UC) | 6 - 12 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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MSOT, Optoacoustics, Photoacoustics