Prediction of early mucosal healing of Crohn’s disease after treatment with biologics- a novel nomogram based on radiomics and clinical risk factors

BackgroundPredicting endoscopic remission is crucial for optimizing clinical treatment strategies and switching biologics in Crohn’s disease (CD). Mucosal healing (MH) is a key therapeutic target. This study aimed to develop a clinically applicable prediction model for early MH in CD patients receiv...

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Main Authors: Linlin Huang, Hui Li, Shuo Wang, Ying Ren
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-05-01
Series:Frontiers in Pharmacology
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Online Access:https://www.frontiersin.org/articles/10.3389/fphar.2025.1586300/full
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author Linlin Huang
Hui Li
Shuo Wang
Ying Ren
author_facet Linlin Huang
Hui Li
Shuo Wang
Ying Ren
author_sort Linlin Huang
collection DOAJ
description BackgroundPredicting endoscopic remission is crucial for optimizing clinical treatment strategies and switching biologics in Crohn’s disease (CD). Mucosal healing (MH) is a key therapeutic target. This study aimed to develop a clinically applicable prediction model for early MH in CD patients receiving biological therapy.MethodsThis study retrospectively analyzed 120 CD patients diagnosed between 2018 and 2023, randomly divided into a training cohort and an internal validation cohort 1. Additionally, 34 prospectively enrolled CD patients diagnosed between 2024 and 2025 formed an internal validation cohort 2. Clinical indicators and conventional imaging features were evaluated to establish a clinical model. Radiomics features were extracted from computed tomography enterography (CTE) images, with regions of interest (ROIs) manually delineated to align with ulcerated intestinal segments identified through colonoscopy. A radiomics model was constructed, and a radiomics score (Rad-score) was derived. A clinical-radiomics nomogram was then developed by integrating Rad-score with clinical risk factors. Model performance was assessed using discrimination, calibration, decision curve analysis (DCA), and clinical impact curves.ResultsThe clinical-radiomics nomogram demonstrated strong predictive performance, with AUC values of 0.948 (95% CI: 0.902–0.995) in the training cohort, 0.925 (95% CI: 0.805–1.0) in the internal validation cohort 1, and 0.940 (95% CI: 0.802–0.993) in the internal validation cohort 2. The nomogram outperformed standalone clinical and radiomics models, with DCA confirming its clinical utility.ConclusionThe developed nomogram effectively predicts early MH in CD patients undergoing biological therapy, providing a practical tool for clinicians to optimize treatment strategies and improve outcomes.
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spelling doaj-art-facdb3018c3c413f8841bcde01d190ab2025-08-20T03:13:30ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122025-05-011610.3389/fphar.2025.15863001586300Prediction of early mucosal healing of Crohn’s disease after treatment with biologics- a novel nomogram based on radiomics and clinical risk factorsLinlin Huang0Hui Li1Shuo Wang2Ying Ren3Department of Radiology, Shengjing Hospital of China Medical University, Shenyang, ChinaDepartment of Digestive, Shengjing Hospital of China Medical University, Shenyang, ChinaDepartment of Radiology, Shengjing Hospital of China Medical University, Shenyang, ChinaDepartment of Radiology, Shengjing Hospital of China Medical University, Shenyang, ChinaBackgroundPredicting endoscopic remission is crucial for optimizing clinical treatment strategies and switching biologics in Crohn’s disease (CD). Mucosal healing (MH) is a key therapeutic target. This study aimed to develop a clinically applicable prediction model for early MH in CD patients receiving biological therapy.MethodsThis study retrospectively analyzed 120 CD patients diagnosed between 2018 and 2023, randomly divided into a training cohort and an internal validation cohort 1. Additionally, 34 prospectively enrolled CD patients diagnosed between 2024 and 2025 formed an internal validation cohort 2. Clinical indicators and conventional imaging features were evaluated to establish a clinical model. Radiomics features were extracted from computed tomography enterography (CTE) images, with regions of interest (ROIs) manually delineated to align with ulcerated intestinal segments identified through colonoscopy. A radiomics model was constructed, and a radiomics score (Rad-score) was derived. A clinical-radiomics nomogram was then developed by integrating Rad-score with clinical risk factors. Model performance was assessed using discrimination, calibration, decision curve analysis (DCA), and clinical impact curves.ResultsThe clinical-radiomics nomogram demonstrated strong predictive performance, with AUC values of 0.948 (95% CI: 0.902–0.995) in the training cohort, 0.925 (95% CI: 0.805–1.0) in the internal validation cohort 1, and 0.940 (95% CI: 0.802–0.993) in the internal validation cohort 2. The nomogram outperformed standalone clinical and radiomics models, with DCA confirming its clinical utility.ConclusionThe developed nomogram effectively predicts early MH in CD patients undergoing biological therapy, providing a practical tool for clinicians to optimize treatment strategies and improve outcomes.https://www.frontiersin.org/articles/10.3389/fphar.2025.1586300/fullCrohn’s diseasemucosal healingbiologicscomputed tomography enterographyradiomics
spellingShingle Linlin Huang
Hui Li
Shuo Wang
Ying Ren
Prediction of early mucosal healing of Crohn’s disease after treatment with biologics- a novel nomogram based on radiomics and clinical risk factors
Frontiers in Pharmacology
Crohn’s disease
mucosal healing
biologics
computed tomography enterography
radiomics
title Prediction of early mucosal healing of Crohn’s disease after treatment with biologics- a novel nomogram based on radiomics and clinical risk factors
title_full Prediction of early mucosal healing of Crohn’s disease after treatment with biologics- a novel nomogram based on radiomics and clinical risk factors
title_fullStr Prediction of early mucosal healing of Crohn’s disease after treatment with biologics- a novel nomogram based on radiomics and clinical risk factors
title_full_unstemmed Prediction of early mucosal healing of Crohn’s disease after treatment with biologics- a novel nomogram based on radiomics and clinical risk factors
title_short Prediction of early mucosal healing of Crohn’s disease after treatment with biologics- a novel nomogram based on radiomics and clinical risk factors
title_sort prediction of early mucosal healing of crohn s disease after treatment with biologics a novel nomogram based on radiomics and clinical risk factors
topic Crohn’s disease
mucosal healing
biologics
computed tomography enterography
radiomics
url https://www.frontiersin.org/articles/10.3389/fphar.2025.1586300/full
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