GIQuant

GIQuant is a software tool developed by Motilent that converts cine (dynamic) MRI sequences into a quantitative motility score for the small bowel. It is designed for use in the assessment of Crohn's disease activity in both adults and children, and holds CE marking (Class IIa) and FDA clearance (Class II). The tool is intended for radiologists, gastroenterologists, and clinical researchers who require an objective, reproducible measure of bowel motility to support treatment decisions, disease monitoring, and clinical trials.

Conventional MRI assessment of Crohn's disease relies on subjective interpretation of structural changes such as wall thickening, ulceration, or strictures, which often appear late in the disease process. GIQuant addresses this by measuring bowel movement directly from cine MRI data, providing a numerical motility score that can be tracked over time and compared across sites, reducing variability in image interpretation.

Key Capabilities

• Quantifies small bowel movement from cine MRI sequences, producing an objective motility score.
• Research suggests motility changes can appear before visible structural changes on MRI, potentially enabling earlier detection of treatment response or disease progression.
• Supports treatment monitoring by tracking motility scores over time in response to biologics and other therapies.
• Being explored as a tool to assess motility in stricturing Crohn's disease, including fibrostenotic disease where structural imaging alone may be insufficient.
• Supported by more than fifty peer-reviewed publications and hundreds of scientific abstracts in paediatric and adult Crohn's disease.
• Regulatory clearance for use in adults and children with routine MR enterography (MRE) data.
• Works directly with standard cine MRI data and integrates into existing radiology workflows.

How GIQuant Works

1. Acquire cine MRI: Short breath-hold cine MRI sequences of the small bowel are obtained as part of routine MRE. No special acquisition protocol is required beyond standard cine sequences.
2. Automated processing: GIQuant generates a reference image and a heatmap. The user draws a region of interest (ROI) around the bowel segment of interest on the reference image.
3. Analyse motility: A validated image registration algorithm measures bowel movement across frames, tracking each pixel's displacement to calculate a motility map.
4. Generate a motility score: The software outputs a quantitative GIQuant score for the defined segment. Lower scores indicate reduced movement, often associated with active Crohn's disease; higher scores reflect normal or vigorous peristalsis.
5. Review and report: Scores can be trended over time to monitor treatment response or disease progression, and can be included in radiology reports or used in research and clinical trial datasets.

Interpreting GIQuant Scores

• Normal scores (200–400) are generally consistent with healthy bowel peristalsis.
• Lower scores (below 200) indicate reduced motility, often associated with active inflammation, stricturing, or impaired function.
• Higher scores (above 400) reflect vigorous peristaltic activity.
• Motility scores are expressed in arbitrary motility units and should be interpreted alongside established clinical and imaging findings such as wall thickness, enhancement, MaRIA, and SES-CD.
• Motility changes can appear months before structural changes are visible on MRI.
• Rising GIQuant scores can indicate treatment response; falling scores may indicate worsening disease or fibrostenosis.
• Reference ranges are based on research cohorts and should not be used in isolation for clinical decision-making.

Clinical Use Cases

• Radiologists: GIQuant can be incorporated into MR enterography reporting to add an objective, quantified variable alongside subjective structural assessment, improving consistency across readers and supporting MDT communication.
• Gastroenterologists (adult and paediatric): GIQuant results can be used alongside endoscopy, biomarkers, and clinical data to guide treatment decisions and monitor response in both children and adults.
• Research and clinical trials: GIQuant provides a standardised, objective motility score that can be incorporated into multi-centre studies and drug development programmes, with potential to identify non-responders earlier and reduce trial size and duration.
• Some centres have reduced or eliminated routine gadolinium contrast use in follow-up MRE studies, substituting motility sequences and using GIQuant to quantify changes over time.

Published Evidence

• Motility changes detected within 8 weeks of biologic therapy in paediatric Crohn's disease, preceding visible structural changes on MRI.
• GIQuant scores correlate with histological findings and show significant agreement with endoscopic and radiological markers of inflammation.
• Reduced motility scores observed in diseased bowel segments compared with unaffected bowel.
• GIQuant helps distinguish inflammatory from fibrostenotic strictures in stricturing Crohn's disease.
• GIQuant predicts clinical outcomes in fibrostenotic disease where structural MRI does not.
• GIQuant has been shown to improve consistency among less experienced radiologists.
• Inter- and intra-observer variability has been assessed in the MOTILITY trial.
• GIQuant has been used in multi-centre studies to standardise Crohn's disease activity assessment across sites.

Integration and Deployment

• DICOM compatible, working directly with standard cine MRI sequences from existing MRE protocols.
• Can be installed within hospital infrastructure and integrates with existing PACS systems; all patient data is processed on premises with no external data transfer, supporting GDPR compliance.
• No dedicated hardware is required; connects via existing trusted pathways including IEP (UK) and Powershare (North America), or dedicated gateways.
• For research and data management projects, GIQuant may also be accessed via Entrolytics, Motilent's cloud-based platform.
• Can be applied retrospectively to existing cine MRI datasets for research or audit purposes.
• Motility scores and maps can be exported or incorporated into radiology reports and clinical trial datasets.
• Multi-centre ready, supporting standardised motility assessment across sites in collaborative studies.

GIQuant is currently being investigated in additional conditions beyond Crohn's disease, including Parkinson's disease, ulcerative colitis, and broader small bowel and gastric dysmotility. Active research programmes include the NIHR i4i-funded Context Trial and the METEOR study, which aims to establish MRE predictors of early disease relapse in Crohn's disease after stopping biologic therapy.