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Isolated recto-sigmoid colitis: a new imaging pattern of ipilimumab-associated colitis.

Publication ,  Journal Article
Barina, AR; Bashir, MR; Howard, BA; Hanks, BA; Salama, AK; Jaffe, TA
Published in: Abdom Radiol (NY)
February 2016

PURPOSE: The purpose of this study is to describe typical CT findings and distinct imaging patterns of ipilimumab-associated colitis in immunotherapeutic treatment of melanoma. MATERIALS AND METHODS: This HIPAA-compliant retrospective study included 86 patients with melanoma imaged with CT or PET/CT of the abdomen and pelvis during or shortly after administration of ipilimumab. Twelve of 86 patients (14%) developed symptoms of colitis and underwent CT imaging of the abdomen and pelvis while symptomatic. Two radiologists reviewed CT images to evaluate for the presence of CT findings of colitis including mesenteric vessel engorgement, pericolonic inflammatory change, hyperenhancement of colonic mucosa, colonic wall thickening, fluid-filled colonic distension, pneumoperitoneum, pneumatosis, and diverticulosis in the inflamed segment of colon. One nuclear medicine radiologist reviewed PET images for abnormally increased FDG uptake in the colon. The diagnosis of ipilimumab-associated colitis was made based on clinical presentation, imaging findings, and laboratory data. RESULTS: Common CT findings of ipilimumab-associated colitis included colonic mucosal hyperenhancement (10/12 [83%]), mesenteric vessel engorgement (9/12 [75.0%]), colonic wall thickening (9/12 [75%]), and pericolonic fat stranding (2/12 [16%]). No patient developed pneumatosis or pneumoperitoneum. Diffuse colitis was present in 4/12 (33%) patients. Segmental colitis with associated diverticulosis (was present in 2/12 (17%) patients). A third pattern, isolated recto-sigmoid colitis without diverticulosis, was observed in 6/12 (50%) patients. All patients with colitis demonstrated recto-sigmoid involvement. CONCLUSIONS: A third radiologic pattern of ipilimumab-associated colitis was observed in this study: isolated recto-sigmoid colitis without diverticulosis. All patterns of ipilimumab-associated colitis include recto-sigmoid involvement.

Duke Scholars

Published In

Abdom Radiol (NY)

DOI

EISSN

2366-0058

Publication Date

February 2016

Volume

41

Issue

2

Start / End Page

207 / 214

Location

United States

Related Subject Headings

  • Tomography, X-Ray Computed
  • Retrospective Studies
  • Radiopharmaceuticals
  • Positron Emission Tomography Computed Tomography
  • Middle Aged
  • Melanoma
  • Male
  • Ipilimumab
  • Iopamidol
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Barina, A. R., Bashir, M. R., Howard, B. A., Hanks, B. A., Salama, A. K., & Jaffe, T. A. (2016). Isolated recto-sigmoid colitis: a new imaging pattern of ipilimumab-associated colitis. Abdom Radiol (NY), 41(2), 207–214. https://doi.org/10.1007/s00261-015-0560-3
Barina, Andrew R., Mustafa R. Bashir, Brandon A. Howard, Brent A. Hanks, April K. Salama, and Tracy A. Jaffe. “Isolated recto-sigmoid colitis: a new imaging pattern of ipilimumab-associated colitis.Abdom Radiol (NY) 41, no. 2 (February 2016): 207–14. https://doi.org/10.1007/s00261-015-0560-3.
Barina AR, Bashir MR, Howard BA, Hanks BA, Salama AK, Jaffe TA. Isolated recto-sigmoid colitis: a new imaging pattern of ipilimumab-associated colitis. Abdom Radiol (NY). 2016 Feb;41(2):207–14.
Barina, Andrew R., et al. “Isolated recto-sigmoid colitis: a new imaging pattern of ipilimumab-associated colitis.Abdom Radiol (NY), vol. 41, no. 2, Feb. 2016, pp. 207–14. Pubmed, doi:10.1007/s00261-015-0560-3.
Barina AR, Bashir MR, Howard BA, Hanks BA, Salama AK, Jaffe TA. Isolated recto-sigmoid colitis: a new imaging pattern of ipilimumab-associated colitis. Abdom Radiol (NY). 2016 Feb;41(2):207–214.
Journal cover image

Published In

Abdom Radiol (NY)

DOI

EISSN

2366-0058

Publication Date

February 2016

Volume

41

Issue

2

Start / End Page

207 / 214

Location

United States

Related Subject Headings

  • Tomography, X-Ray Computed
  • Retrospective Studies
  • Radiopharmaceuticals
  • Positron Emission Tomography Computed Tomography
  • Middle Aged
  • Melanoma
  • Male
  • Ipilimumab
  • Iopamidol
  • Humans