The EXTENT Study: Results From an International Expert Delphi Consensus to Define Ultrasonographic Parameters for Measuring Bowel Damage in Crohn's Disease.

Background & Aims: A primary aim in managing Crohn's disease (CD) is preventing bowel damage. The Lémann index (LI) quantifies structural bowel damage using magnetic resonance enterography (MRE) or computed tomography enterography (CTE) and, for colonic CD, colonoscopy. Intestinal ultrasonography (IUS) provides a noninvasive imaging alternative, although its role in LI assessment remains unexplored.

Oxygen-Enhanced R2* Weighted MRI and Diffusion Weighted MRI of Head and Neck Squamous Cell Cancer Lymph Nodes in Prediction of 2-Year Outcome Following Chemoradiotherapy.

Background: We evaluated the utility of HNSCC LN R2* relaxation times to infer the oxygenation status of LN non-invasively at baseline and when breathing air and 100% oxygen to predict chemoradiotherapeutic locoregional response at 2 years. Hypoxia within LNs has been associated with poorer outcomes following CRT. Deoxyhaemoglobin decreases MRI transverse relaxation time (T2*) (lengthening inverse, R2*).

Expert Position Statement: Defining the Role of Intestinal Ultrasound in Assessing Constipation and Faecal Loading.

Background: Intestinal ultrasound has been proposed as a tool to assess non-inflammatory functional gastrointestinal disorders, including constipation and faecal loading. However, well-defined sonographic criteria for these conditions are currently lacking.

Aim: To identify and establish specific sonographic parameters that could be used to assess constipation and faecal loading with intestinal ultrasound.

British Society of Gastroenterology guidelines on inflammatory bowel disease in adults: 2025.

In response to recent advancements in inflammatory bowel disease (IBD) management, the British Society of Gastroenterology (BSG) Clinical Services and Standards Committee (CSSC) has commissioned the BSG IBD section to update its guidelines, last revised in 2019. These updated guidelines aim to complement the IBD standards and promote the use of the national primary care diagnostic pathway for lower gastrointestinal symptoms to enhance diagnostic accuracy and timeliness. Formulated through a systematic and transparent process, this document reflects a consensus of best practices based on current evidence.

ESR Essentials: diagnosis and assessment of treatment response in patients with luminal Crohn's disease-practice recommendations by the European Society of Gastrointestinal and Abdominal Radiology.

The European Society of Gastrointestinal and Abdominal Radiology (ESGAR) presents an ESR Essentials review article on Crohn's disease (CD) diagnosis and treatment response assessment. The focus is on luminal disease, particularly in the small bowel, and to a lesser degree, the colon. Magnetic Resonance Enterography (MRE) and ultrasound are typically the first-line radiological investigations for known or suspected luminal CD.

Role of Noninvasive Imaging in the Diagnosis and Management of Patients With Suspected and Established Inflammatory Bowel Disease.

In a treat-to-target era, objective disease assessment in inflammatory bowel disease has become increasingly important. For many years, endoscopy has been generally accepted as the gold standard for evaluating the bowel mucosa, additionally facilitating biopsy. However, noninvasive disease assessment is now increasingly demanded, and cross-sectional imaging techniques, as well as video capsule endoscopy, have markedly improved.

Quantified motility assessment in paediatric inflammatory bowel disease: a multi-reader study.

Background: Quantitative bowel motility in inflammatory bowel disease using magnetic resonance enterography (MRE) shows promise as a biomarker of disease activity against histopathological and biochemical markers of inflammation when used by experienced readers in a research setting.

Objective: The aim of this study was to test multi-reader agreement in quantified bowel motility by non-experienced readers.

Materials And Methods: A single-centre, retrospective search included all patients <18 years with paediatric inflammatory bowel disease and more than one MRE between 2012-2022.

Inter- and intra-observer variability of software quantified bowel motility measurements of small bowel Crohn's disease: findings from the MOTILITY trial.

Objectives: Motility magnetic resonance imaging (mMRI) is a potential marker of disease activity of small bowel Crohn's disease (SBCD), but there is limited data on its reproducibility. We assessed inter- and intra-observer agreement of small bowel motility as part of a prospective multicentre trial investigating whether mMRI can predict longer-term response to biologic therapy in active, non-stricturing SB-CD (MOTILITY Trial).

Methods: 297 segmental small bowel motility scores from 104 SBCD patients (mean age 38.

Magnetic resonance enterography to predict subsequent disabling Crohn's disease in newly diagnosed patients (METRIC-EF)-multivariable prediction model, multicentre diagnostic inception cohort.

Objectives: Magnetic resonance enterography (MRE) is a first-line investigation to diagnose Crohn's disease (CD), but its role for prognostication is unknown. Accordingly, we assessed the predictive ability of prognostic models including MRE scores (MRE Global Score (MEGS), simplified MR Index of Activity (sMARIA), and Lémann index (LI)) against models using clinical predictors alone for the development of modified Beaugerie disabling CD (MBDD) within 5 years of diagnosis.

Methods: This was a multicentre, diagnostic inception cohort of patients with newly diagnosed CD across 9 UK hospitals, followed for 4 years or more.

MRI assessment of body composition for prediction of therapeutic response to biologic agents in patients with Crohn's disease.

Objectives: Altered body fat and muscle mass in Crohn's disease (CD) have been linked to adverse disease course and outcomes. Prediction of treatment response or remission (RoR) of small bowel CD (SBCD) to biologic therapy remains challenging. We aimed to establish the prognostic value of body composition parameters measured using MR enterography (MRE) for RoR at 1 year in patients with SBCD commencing biologic therapy.

CT Colonography for Colorectal Cancer Prevention and Detection: Integration Into Clinical Practice, From the Special Series on Screening.

CT colonography (CTC) is a CT examination, performed with low dose and typically without IV contrast media, optimized to detect colorectal polyps and cancer. Despite extensive supporting data, CTC has had variable acceptance and use over the past two decades, particularly for a main indication of colorectal cancer screening. CTC is now at an inflection point after the approval in 2025 by CMS for reimbursement of CTC performed for colorectal cancer screening.

A British Society of Gastrointestinal and Abdominal Radiology multi-centre audit of imaging investigations in inflammatory bowel disease.

Objectives: To evaluate current UK practice for inflammatory bowel disease (IBD) imaging against recommendations from published international literature.

Methods: A retrospective multi-centre audit was undertaken evaluating imaging modalities, protocols, and pathways used to investigate IBD both in outpatient and inpatient settings during January-December 2022. Reporting practices and training provisions were also recorded.

Small Bowel Motility Quantified by Cine MRI to Predict Longer-Term Response in Patients with Crohn's Disease Commencing Biological Therapy: The Motility Study.

Background: Small bowel Crohn's disease (SBCD) is increasingly treated with biological therapies. Predicting response or remission (RoR) for individual patients is difficult and complicates treatment strategy. We aimed to determine if motility magnetic resonance imaging (mMRI) is superior to CRP and fecal calprotectin (FC) for the prediction of RoR at 1 year in patients commencing biologics for SBCD.

How I Do It: Cross-sectional Imaging in Small-Bowel Crohn Disease and Ulcerative Colitis.

Cross-sectional imaging, especially MR enterography (MRE) and intestinal US, plays an increasingly important role in the diagnosis and monitoring of Crohn disease. In this article, the authors share their approach to imaging Crohn disease, drawing on their clinical and research experience. They consider how to select the most appropriate modality for different clinical indications and discuss technical aspects to maximize diagnostic accuracy.

Diffusion-weighted imaging to predict longer-term response in Crohn's disease patients commencing biological therapy: results from the MOTILITY trial.

Objectives: Predicting longer-term response to biological therapy for small bowel Crohn's disease (SBCD) is an unmet clinical need. Diffusion-weighted magnetic resonance (MR) imaging (DWI) may indicate disease activity, but its predictive ability, if any, is unknown. We investigated the prognostic value of DWI for 1 year response or remission (RoR) in SBCD patients commencing biologic therapy, including incremental value over C-reactive protein (CRP) and faecal calprotectin (FC).

Quantified small bowel motility assessment on magnetic resonance enterography in paediatric inflammatory bowel disease - does it reflect clinical response?

Background: Quantified small bowel motility assessment using cine magnetic resonance enterography (MRE) has shown promise as a biomarker in adult inflammatory bowel disease. Whether quantified motility corresponds to treatment response in paediatric inflammatory bowel disease is unknown.

Objective: To test whether changes in motility reflect response.

International expert guidance for defining and monitoring small bowel strictures in Crohn's disease on intestinal ultrasound: a consensus statement.

Background: Diagnostic imaging using CT enterography, magnetic resonance enterography, and intestinal ultrasound are important tools in evaluating stricturing Crohn's disease. Definitions of strictures have been developed for CT enterography and magnetic resonance enterography. However, expert recommendations for definitions and treatment response of strictures on intestinal ultrasound are not available.

Combined MRI, high-resolution manometry and a randomised trial of bisacodyl versus hyoscine show the significance of an enlarged colon in constipation: the RECLAIM study.

Background: Colonic motility in constipation can be assessed non-invasively using MRI.

Objective: To compare MRI with high-resolution colonic manometry (HRCM) for predicting treatment response.

Design: Part 1: 44 healthy volunteers (HVs), 43 patients with irritable bowel syndrome with constipation (IBS-C) and 37 with functional constipation (FC) completed stool diaries and questionnaires and underwent oral macrogol (500-1000 mL) challenge.

Biomechanical Assessment of Liver Integrity: Prospective Evaluation of Mechanical Versus Acoustic MR Elastography.

Background: Magnetic resonance elastography (MRE) can quantify tissue biomechanics noninvasively, including pathological hepatic states like metabolic dysfunction-associated steatohepatitis.

Purpose: To compare the performance of 2D/3D-MRE using the gravitational (GT) transducer concept with the current commercial acoustic (AC) solution utilizing a 2D-MRE approach. Additionally, quality index markers (QIs) were proposed to identify image pixels with sufficient quality for reliably estimating tissue biomechanics.

Reliability of CT Enterography for Describing Fibrostenosing Crohn Disease.

Background Standardized methods to measure and describe Crohn disease strictures at CT enterography are needed to guide clinical decision making and for use in therapeutic studies. Purpose To assess the reliability of CT enterography features to describe Crohn disease strictures and their correlation with stricture severity. Materials and Methods A retrospective study was conducted in 43 adult patients with symptomatic terminal ileal Crohn disease strictures who underwent standard-of-care CT enterography at a tertiary care center at the Cleveland Clinic between January 2008 and August 2016.