Disagreement among Gastroenterologists in the Endoscopic Evaluation Using the Mayo Endoscopic Score and the Rutgeerts Postoperative Score

reference standard.MTR was evaluated as secondary and apparent diffusion coefficient (ADC) as exploratory objective.Methods: Informed consent was obtained from 51 stenotic CD patients eligible for resection surgery across 6 European centers in a prospective trial evaluating MRE for the detection of fibrosis in CD.Imaging was performed a median of two weeks (>90% <8 weeks) prior to surgery with no treatment changes in between.Local pathologists and radiologists annotated the location of 56 histological samples on the MRE scans, which was identified in the most stenosed region of corresponding resected specimens.An experienced pathologist centrally read the 56 samples using the Chiorean score. 2 A single radiologist measured DGE, MTR, T2, ADC, and MaRIA index. 1, 3 Correlation of histology and MRE metrics was performed using Pearson's R. Results: No association of fibrosis or inflammation with either DGE or MTR was found (fig 1).ADC was associated with fibrosis (R=-0.36,p=0.011).MaRIA score was correlated with inflammation (0.31, 0.031).Monitoring of image data quality by central reader resulted in >95% evaluable scans.Conclusions: In this prospective, multi-center study, DGE and MTR were not found to be in concordance with histological measure of fibrosis, in contrast to previously published findings.This may have been due to a spatial mismatch between histological tissue sample and imaging measurement region of interest, inconsistencies in the interval between imaging and surgery, the effects of histological preparation, or lack of granularity in histological scoring.However MaRIA scores were in good agreement with inflammation scoring, so it is possible that MRE metrics assist in the assessment of CD stenosis.Further development of histological scores and MRE metrics will inform upon MRE protocol development in CD.