To Örebro University

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.