Title: Different imaging techniques' diagnostic efficacy for Crohn's disease activity and external
validation and comparison of MDCTAs, SES-CD and IBUS-SAS
Version: 1 Date: 22 Jul 2024
Reviewer's report:
In this work by Long et al. , the authors present the results of a cohort of CD patients, whose
disease activity has been assessed with different imaging techniques (MDCTES, SES-CD and
IBUS-SAS).  Clinical activity has been used as reference. The article addresses a hot topic of
IBD diagnosing/monitoring and I believe it could merit further evaluation once the issues below
are solved.
MAJOR COMMENTS:
- Crohn’s disease is often subtle with poor correlation between clinical activity and objective
signs of inflammation (at endoscopy and IUS/radiology). Therefore, I think that the manuscript
should be restructured with a focus on the direct comparison between IBUS-SAS, SES-CD and
MDCTES, leaving their correlation with clinical activity and biomarkers as side data. I would
recommend using SES-CD as the gold standard of disease activity, and MDCTES in case of
disease that cannot be assessed by endoscopy (e.g. preterminal ileum or jejunum). By doing this,
one can show how IUS (specifically here IBUS-SAS) can effectively correlate and be a valid
substitute of these techniques.
- Which segment was evaluated in the analysis? Were the most affected areas matched across
different techniques? E.g. terminal ileum evaluation of IBUS-SAS with the segmental SES-CD
of this region and the same for MDCTES. Or did the authors take the full score resulting from
adding up each segment to have the whole score? This should be specified in the method section.
I suggest considering only the most affected area for each patient and specify this in the method
section.
MINOR COMMENTS
- results section of the abstract: the sentence "Delong test showed that IBUS-SAS vs SES-CD (z
= 3.244, p = 0.001) and IBUS-SAS vs MDCTEs (z = 2.180, P = 0.029). " should be rephrased.
- introduction is too long and should be more concise and cut to the point
- to help the reader, I suggest to add a table where all the scores' parameters are resumed (for
SES-CD, IBUS-SAS and MDCTES)
- when referring to the number of patients, the decimal is not necessary (e.g., 12.0 patients with
L1 disease)
- discussion section should be re-structured based on the major comments above
- table 2, 4, and 6 cannot be evaluated (problems with formatting)
- revision of the manuscript by a native english speaker is recommended for language polishing
Title: Different imaging techniques' diagnostic efficacy for Crohn's disease activity and external
validation and comparison of MDCTAs, SES-CD and IBUS-SAS
Version: 1 Date: 22 Jul 2024
Reviewer's report:
In this work by Long et al. , the authors present the results of a cohort of CD patients, whose
disease activity has been assessed with different imaging techniques (MDCTES, SES-CD and
IBUS-SAS).  Clinical activity has been used as reference. The article addresses a hot topic of
IBD diagnosing/monitoring and I believe it could merit further evaluation once the issues below
are solved.
MAJOR COMMENTS:
- Crohn’s disease is often subtle with poor correlation between clinical activity and objective
signs of inflammation (at endoscopy and IUS/radiology). Therefore, I think that the manuscript
should be restructured with a focus on the direct comparison between IBUS-SAS, SES-CD and
MDCTES, leaving their correlation with clinical activity and biomarkers as side data. I would
recommend using SES-CD as the gold standard of disease activity, and MDCTES in case of
disease that cannot be assessed by endoscopy (e.g. preterminal ileum or jejunum). By doing this,
one can show how IUS (specifically here IBUS-SAS) can effectively correlate and be a valid
substitute of these techniques.
- Which segment was evaluated in the analysis? Were the most affected areas matched across
different techniques? E.g. terminal ileum evaluation of IBUS-SAS with the segmental SES-CD
of this region and the same for MDCTES. Or did the authors take the full score resulting from
adding up each segment to have the whole score? This should be specified in the method section.
I suggest considering only the most affected area for each patient and specify this in the method
section.
MINOR COMMENTS
- results section of the abstract: the sentence "Delong test showed that IBUS-SAS vs SES-CD (z
= 3.244, p = 0.001) and IBUS-SAS vs MDCTEs (z = 2.180, P = 0.029). " should be rephrased.
- introduction is too long and should be more concise and cut to the point
- to help the reader, I suggest to add a table where all the scores' parameters are resumed (for
SES-CD, IBUS-SAS and MDCTES)
- when referring to the number of patients, the decimal is not necessary (e.g., 12.0 patients with
L1 disease)
- discussion section should be re-structured based on the major comments above
- table 2, 4, and 6 cannot be evaluated (problems with formatting)
- revision of the manuscript by a native english speaker is recommended for language polishing
Please review this paper.
user
Title: Different imaging techniques' diagnostic efficacy for Crohn's disease activity and external
validation and comparison of MDCTAs, SES-CD and IBUS-SAS
Version: 1 Date: 22 Jul 2024
Reviewer's report:
In this work by Long et al. , the authors present the results of a cohort of CD patients, whose
disease activity has been assessed with different imaging techniques (MDCTES, SES-CD and
IBUS-SAS).  Clinical activity has been used as reference. The article addresses a hot topic of
IBD diagnosing/monitoring and I believe it could merit further evaluation once the issues below
are solved.
MAJOR COMMENTS:
- Crohn’s disease is often subtle with poor correlation between clinical activity and objective
signs of inflammation (at endoscopy and IUS/radiology). Therefore, I think that the manuscript
should be restructured with a focus on the direct comparison between IBUS-SAS, SES-CD and
MDCTES, leaving their correlation with clinical activity and biomarkers as side data. I would
recommend using SES-CD as the gold standard of disease activity, and MDCTES in case of
disease that cannot be assessed by endoscopy (e.g. preterminal ileum or jejunum). By doing this,
one can show how IUS (specifically here IBUS-SAS) can effectively correlate and be a valid
substitute of these techniques.
- Which segment was evaluated in the analysis? Were the most affected areas matched across
different techniques? E.g. terminal ileum evaluation of IBUS-SAS with the segmental SES-CD
of this region and the same for MDCTES. Or did the authors take the full score resulting from
adding up each segment to have the whole score? This should be specified in the method section.
I suggest considering only the most affected area for each patient and specify this in the method
section.
MINOR COMMENTS
- results section of the abstract: the sentence "Delong test showed that IBUS-SAS vs SES-CD (z
= 3.244, p = 0.001) and IBUS-SAS vs MDCTEs (z = 2.180, P = 0.029). " should be rephrased.
- introduction is too long and should be more concise and cut to the point
- to help the reader, I suggest to add a table where all the scores' parameters are resumed (for
SES-CD, IBUS-SAS and MDCTES)
- when referring to the number of patients, the decimal is not necessary (e.g., 12.0 patients with
L1 disease)
- discussion section should be re-structured based on the major comments above
- table 2, 4, and 6 cannot be evaluated (problems with formatting)
- revision of the manuscript by a native english speaker is recommended for language polishing
assistant