International Magnetic Resonance Imaging Consensus for use in Luminal Crohn's Disease Trials and Clinical Practice

Bénédicte Caron¹, Vipul Jairath², Bruce E Sands³, David T Rubin⁴, Mariangela Allocca⁵, Valérie Laurent⁶, Kerri Novak⁷, Remo Panaccione⁸, Peter Bossuyt⁹, David H Bruining¹⁰, Axel Dignass¹¹, Iris Dotan¹², Joel Fletcher¹³, Mathurin Fumery¹⁴, Federica Furfaro⁵, Jonas Halfvarson¹⁵, Ailsa Hart¹⁶, Taku Kobayashi¹⁷, Noa Krugliak Cleveland⁴, Torsten Kucharzik¹⁸, Andrea Laghi¹⁹, Peter L Lakatos²⁰, Rupert W Leong²¹, Edward V Loftus Jr²², Edouard Louis²³, Fernando Magro²⁴, Pablo A Olivera²⁵, Sebastien Shaji²⁶, Britta Siegmund²⁷, Stephan R Vavricka²⁸, Silvio Danese⁵, Jaap Stoker²⁹, Laurent Peyrin-Biroulet³⁰

Affiliations

¹ University of Lorraine, Nancy University Hospital, Inserm, INFINY Institute, NGERE, F-54000 Nancy France.
² Translational Gastroenterology Unit, Nuffield Department of Medicine, John Radcliffe Hospital, Oxford, UK; Lawson Health Research Institute, London Health Science Centre, London, Ontario, Canada; Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada.
³ Dr. Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
⁴ University of Chicago Medicine, Inflammatory Bowel Disease Center, Chicago, USA.
⁵ IRCCS Hospital San Raffaele and University Vita-Salute San Raffaele, Gastroenterology and Endoscopy, Milan, Italy.
⁶ Department of Radiology, University Hospital of Nancy, Laboratoire IADI INSERM U 1254, 54035 Nancy, France.
⁷ Cumming School of Medicine, University of Calgary, AB, Canada.
⁸ Inflammatory Bowel Disease Unit, Division of Gastroenterology and Hepatology, University of Calgary, Calgary, CANADA.
⁹ Imelda GI clinical research center, Imelda General Hospital, Bonheiden, Belgium.
¹⁰ Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN.
¹¹ Department of Medicine I, Agaplesion Markus Hospital, Goethe-University, Frankfurt am Main, Germany.
¹² Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel and Division of Gastroenterology, Rabin Medical Center, Petah Tikva, Israel.
¹³ Department of Radiology, Mayo Clinic, Rochester, Minnesota, United States of America.
¹⁴ Department of Gastroenterology, CHU Amiens and PériTox, UMR-I 01 INERIS, Picardie Jules Verne University, Amiens, France.
¹⁵ Department of Gastroenterology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
¹⁶ IBD Unit, St Mark's Hospital and Imperial College London, London, United Kingdom.
¹⁷ Center for Advanced IBD Research and Treatment, Kitasato University Kitasato Institute Hospital, Tokyo, Japan.
¹⁸ Department of Gastroenterology, Klinikum Lüneburg, Germany; Westfälische Wilhelms Universität Münster, Münster, Germany.
¹⁹ Department of Medical Surgical Sciences and Translational Medicine, Sapienza University of Rome, AOU Sant'Andrea, Rome, ITALY.
²⁰ Division of Gastroenterology and Hepatology, McGill University Health Center, Montreal, Quebec, Canada and Department of Oncology and Medicine, Semmelweis University, Budapest.
²¹ Department of Gastroenterology, Concord Repatriation General Hospital, Sydney, Australia.
²² Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine and Science, Rochester, Minnesota, USA.
²³ Department of gastroenterology, Univeristy Hospital, CHU of Liège, Liège, Belgium.
²⁴ Centre for Health Technology and Services Research, Health Research Network (CINTESIS@RISE), Faculty of Medicine of the University of Porto, Portugal.
²⁵ Zane Cohen Centre for Digestive Diseases, Lunenfeld Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Ontario, Canada; Gastroenterology Section, Department of Internal Medicine, Centro de Educación Médica e Investigaciones Clínicas Norberto Quirno (CEMIC), Buenos Aires, Argentina.
²⁶ IBD Unit, Department of Gastroenterology, Hull University Teaching Hospitals, Hull, UK.
²⁷ Department of Gastroenterology, Infectious Diseases and Rheumatology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
²⁸ Department of Gastroenterology and Hepatology, University Hospital Zurich and University of Zurich, Zurich, Switzerland.
²⁹ Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, The Netherlands and Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam, The Netherlands.
³⁰ University of Lorraine, Nancy University Hospital, Inserm, INFINY Institute, NGERE, F-54000 Nancy France. Electronic address: peyrinbiroulet@gmail.com.

PMID: 40882718
DOI: 10.1016/j.cgh.2025.08.019

International Magnetic Resonance Imaging Consensus for use in Luminal Crohn's Disease Trials and Clinical Practice

Bénédicte Caron et al. Clin Gastroenterol Hepatol. 2025.

. 2025 Aug 27:S1542-3565(25)00739-6.

doi: 10.1016/j.cgh.2025.08.019. Online ahead of print.

Authors

Affiliations

¹ University of Lorraine, Nancy University Hospital, Inserm, INFINY Institute, NGERE, F-54000 Nancy France.
² Translational Gastroenterology Unit, Nuffield Department of Medicine, John Radcliffe Hospital, Oxford, UK; Lawson Health Research Institute, London Health Science Centre, London, Ontario, Canada; Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada.
³ Dr. Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
⁴ University of Chicago Medicine, Inflammatory Bowel Disease Center, Chicago, USA.
⁵ IRCCS Hospital San Raffaele and University Vita-Salute San Raffaele, Gastroenterology and Endoscopy, Milan, Italy.
⁶ Department of Radiology, University Hospital of Nancy, Laboratoire IADI INSERM U 1254, 54035 Nancy, France.
⁷ Cumming School of Medicine, University of Calgary, AB, Canada.
⁸ Inflammatory Bowel Disease Unit, Division of Gastroenterology and Hepatology, University of Calgary, Calgary, CANADA.
⁹ Imelda GI clinical research center, Imelda General Hospital, Bonheiden, Belgium.
¹⁰ Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN.
¹¹ Department of Medicine I, Agaplesion Markus Hospital, Goethe-University, Frankfurt am Main, Germany.
¹² Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel and Division of Gastroenterology, Rabin Medical Center, Petah Tikva, Israel.
¹³ Department of Radiology, Mayo Clinic, Rochester, Minnesota, United States of America.
¹⁴ Department of Gastroenterology, CHU Amiens and PériTox, UMR-I 01 INERIS, Picardie Jules Verne University, Amiens, France.
¹⁵ Department of Gastroenterology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
¹⁶ IBD Unit, St Mark's Hospital and Imperial College London, London, United Kingdom.
¹⁷ Center for Advanced IBD Research and Treatment, Kitasato University Kitasato Institute Hospital, Tokyo, Japan.
¹⁸ Department of Gastroenterology, Klinikum Lüneburg, Germany; Westfälische Wilhelms Universität Münster, Münster, Germany.
¹⁹ Department of Medical Surgical Sciences and Translational Medicine, Sapienza University of Rome, AOU Sant'Andrea, Rome, ITALY.
²⁰ Division of Gastroenterology and Hepatology, McGill University Health Center, Montreal, Quebec, Canada and Department of Oncology and Medicine, Semmelweis University, Budapest.
²¹ Department of Gastroenterology, Concord Repatriation General Hospital, Sydney, Australia.
²² Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine and Science, Rochester, Minnesota, USA.
²³ Department of gastroenterology, Univeristy Hospital, CHU of Liège, Liège, Belgium.
²⁴ Centre for Health Technology and Services Research, Health Research Network (CINTESIS@RISE), Faculty of Medicine of the University of Porto, Portugal.
²⁵ Zane Cohen Centre for Digestive Diseases, Lunenfeld Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Ontario, Canada; Gastroenterology Section, Department of Internal Medicine, Centro de Educación Médica e Investigaciones Clínicas Norberto Quirno (CEMIC), Buenos Aires, Argentina.
²⁶ IBD Unit, Department of Gastroenterology, Hull University Teaching Hospitals, Hull, UK.
²⁷ Department of Gastroenterology, Infectious Diseases and Rheumatology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
²⁸ Department of Gastroenterology and Hepatology, University Hospital Zurich and University of Zurich, Zurich, Switzerland.
²⁹ Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, The Netherlands and Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam, The Netherlands.
³⁰ University of Lorraine, Nancy University Hospital, Inserm, INFINY Institute, NGERE, F-54000 Nancy France. Electronic address: peyrinbiroulet@gmail.com.

PMID: 40882718
DOI: 10.1016/j.cgh.2025.08.019

Abstract

Background and aims: Cross sectional imaging is an integral part of evaluating disease activity and complications in Crohn's disease. There remains a need to develop guidance that may be for both clinical trials and clinical practice. This initiative aimed to develop consensus statements for definitions of response and remission, transmural healing, optimal timing for assessing, and evaluation of treatment efficacy in patients with Crohn's disease using magnetic resonance enterography (MRE) in clinical trials and clinical practice.

Methods: Thirty-three international experts (gastroenterologists (n=29) and radiologists (n=4) participated in a consensus process. A systematic literature review was conducted to inform initial consensus, statements were discussed and voted using a modified Delphi method. Consensus was defined as at least 75% agreement among voters.

Results: The MaRIA score and the simplified MaRIA score should be used to determine response and remission in moderate to severe Crohn's disease. Response was defined as a MaRIA score <11 or an improvement of at least 25%, and a decrease of at least 1 point in the simplified MaRIA score. Remission was defined as a MaRIA score <7 or a simplified MaRIA score <1. Five different definitions were proposed for transmural healing. For the time point of assessment, the group proposed week 24 for response, weeks 24, 52 or 54 for remission, and weeks 52 or 104 for transmural healing.

Conclusion: A consensus expert panel has developed standardized definitions of MRE response, remission, as well as the optimal timing for response assessment in patients with luminal Crohn's disease. Further research is needed to clarify the method for measuring transmural healing.

Keywords: Crohn’s disease; magnetic resonance imaging; remission; response; transmural healing.

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International Magnetic Resonance Imaging Consensus for use in Luminal Crohn's Disease Trials and Clinical Practice

Affiliations

International Magnetic Resonance Imaging Consensus for use in Luminal Crohn's Disease Trials and Clinical Practice

Authors

Affiliations

Abstract

LinkOut - more resources

Full Text Sources