Evaluating luminal and post-operative Crohn’s disease activity on magnetic resonance enterography: A review of radiological disease activity scores

Table 7 Studies comparing the diagnostic utility of radiological disease activity scores using magnetic resonance enterography in luminal Crohn’s disease[19,38,52,53,60,78,79]

Ref.	MRE disease activity scores	Patients	Reference standard	Outcome
Rimola et al[38]	MaRIA; Clermont score; London score	43	Active disease; Ileo-colonoscopy: SES-CD ≥ 2	MaRIA ≥ 7: Sensitivity = 88%, specificity = 97%, AUROC = 0.92; Clermont score > 8.4: Sensitivity = 89%, specificity = 78%, AUROC = 0.84; London score ≥ 4.1: Sensitivity = 71%, specificity = 99%, AUROC = 0.85; MaRIA superior (all P < 0.05)
Buisson et al[60]	MaRIA; Clermont score	44	Active disease; Ileo-colonoscopy: Presence of superficial ulceration	MaRIA ≥ 7: Sensitivity = 51.8%, specificity = 82.1%, AUROC = 0.67; Clermont score > 8.4: Sensitivity = 54.4%, specificity = 81.3%, AUROC = 0.68; No significant differences between scores (P > 0.05)
			Severe disease; Ileo-colonoscopy: Presence of deep ulceration	MaRIA ≥ 11: Sensitivity = 90.9%, specificity = 82.0%, AUROC = 0.86; Clermont score > 12.5: Sensitivity = 90.9%, specificity = 80.0%, AUROC = 0.86; No significant differences between scores (P > 0.05)
Puylaert et al[52]	MaRIA; Clermont score; London score; CDMI	98	Active disease; Ileo-colonoscopy: CDEIS ≥ 3	MaRIA ≥ 7: Sensitivity = 80%-84%, specificity = 62%-65%; Clermont score > 8.4: Sensitivity = 83%-85%, specificity = 64%; London score ≥ 3.4: Sensitivity = 79%-82%, specificity = 68%-71%; CDMI ≥ 3: Sensitivity = 77%-82%, specificity = 68%-71%; No significant differences between scores (all P > 0.05)
			Ulcerating disease; Ileo-colonoscopy: Presence of ulceration	MaRIA ≥ 11: Sensitivity = 76%-83%, specificity = 66%-68%; Clermont score > 12.5: Sensitivity = 79%-83%, specificity = 67%; London score ≥ 3.8: Sensitivity = 80%-83%, specificity = 61%-63%; No significant differences between scores (P > 0.05)
Ordás et al[19]	MaRIA; sMaRIA	98	Active disease; Ileo-colonoscopy: Presence of any lesion	MaRIA ≥ 7: Sensitivity = 81%, specificity = 89%, AUROC = 0.89; sMaRIA ≥ 1: Sensitivity = 90%, specificity = 81%, AUROC = 0.91; No significant differences between scores (P > 0.05)
			Ulcerating disease; Ileo-colonoscopy: Presence of ulceration	MaRIA ≥ 11: Sensitivity = 95%, specificity = 91%, AUROC = 0.97; sMaRIA ≥ 2: Sensitivity = 85%, specificity = 82%, AUROC = 0.94; No significant differences between scores (P > 0.05)
Kumar et al[78]	sMaRIA; London score; CDMI	111	Active disease-HAI cutoff > 0; Biopsy of terminal ileum on ileo-colonoscopy	sMaRIA ≥ 1: Sensitivity= 83%, specificity = 41%; London score ≥ 4.1: Sensitivity = 76%, specificity = 64%; CDMI ≥ 3: Sensitivity = 81%, specificity = 41%; No P value provided
			Active disease-HAI cutoff > 1; Biopsy of terminal ileum on ileo-colonoscopy	sMaRIA ≥ 1: Sensitivity = 90%, specificity: 31%; London score ≥ 4.1: Sensitivity = 86%, specificity: 46%; CDMI ≥ 3: Sensitivity = 88%, specificity = 33%; No P value provided
Lee et al[53]	MaRIA; sMaRIA; Nancy score	61	Active disease; Ileo-colonoscopy: SES-CD ≥ 2	MaRIA ≥ 8.46: Sensitivity = 63.3%, specificity = 87.6%, AUROC = 0.752; sMaRIA ≥ 1: Sensitivity = 64.2%, specificity = 85.0%, AUROC = 0.764; Nancy > 1: Sensitivity = 65.1%, specificity = 83.8%, AUROC = 0.765; No significant differences between scores (all P > 0.05)
			Sub-analysis: Crohn’s disease diagnosis; Active vs inactive disease; Ileo-colonoscopy: SES-CD ≥ 2 vs < 2	MaRIA ≥ 8.46: AUROC = 0.826; sMaRIA ≥ 1: AUROC = 0.802; Nancy > 1: AUROC = 0.847; All scores able to differentiate (all P < 0.05)
			Sub-analysis: Disease monitoring; Active vs inactive disease; Ileo-colonoscopy: SES-CD ≥ 2 vs < 2	MaRIA ≥ 8.46: AUROC = 0.721; sMaRIA ≥ 1: AUROC = 0.741; Nancy > 1: AUROC = 0.652; MaRIA/sMaRIA able (both, P < 0.05) vs Nancy unable (P > 0.05) to differentiate
			Sub-analysis: Flare up or complication assessment; Active and inactive disease differentiation; Ileo-colonoscopy: SES-CD ≥ 2	MaRIA ≥ 8.46: AUROC = 0.761; sMaRIA ≥ 1: AUROC = 0.761; Nancy > 1: AUROC = 0.754; All scores able to differentiate (all P < 0.05)
Bohra et al[79]	MaRIA; sMaRIA; London score; CDMI	137	Active vs inactive disease on high quality MRE; Ileo-colonoscopy: SES-CD ≥ 3	MaRIA ≥ 7: AUROC= 0.838; sMaRIA ≥ 1: AUROC = 0.834; London score ≥ 4.1: AUROC = 0.738; CDMI ≥ 3: AUROC = 0.850; No P value provided
			Active vs inactive disease on low quality MRE; Ileo-colonoscopy: SES-CD ≥ 3	MaRIA ≥ 7: AUROC= 0.634; sMaRIA ≥ 1: AUROC = 0.527; London score ≥ 4.1: AUROC = 0.511; CDMI ≥ 3: AUROC = 0.595; No P value provided; Diagnostic performances reduced on low vs high quality MRE (all P < 0.05)

MRE: Magnetic resonance enterography; MaRIA: Magnetic resonance index of activity; sMaRIA: Simplified magnetic resonance index of activity; CDMI: Crohn’s disease magnetic resonance imaging index; CDEIS: Crohn’s disease endoscopic index of severity; SES-CD: Simple endoscopic score for Crohn’s disease; AUROC: Area under receiver operating characteristic curve; HAI: Histological activity index.