Reviewer ’s report  
 
Title: CT Enterography Score: A Potential Predictor for Severity Assessment of Active 
Ulcerative Colitis  
 
Version: 0 Date: 23 Jan 2018  
 
Reviewer: Govind Makharia  
 
Reviewer's report:  
 
Please include all comments for the authors in this box rather than uploading your report as an 
attachment. Please only uploa d as attachments annotated versions of manuscripts, graphs, 
supporting materials or other aspects of your report which cannot be included in a text format.  
Please overwrite this text when adding your comments to the authors.  
In the present study, the auth ors have reported the utility of CT enterography in evaluating the 
severity of the activity of ulcerative colitis. The authors have demonstrated certain features on 
CT enterography. The images are of very good quality.  
 
Comments  
1. Of all patients, how m any patients had adequate distension of the entire colon? How was the 
adequacy of distension ascertained?  
 
2. It is really difficult to get the recto -sigmoid  
 
3. Could you assess the extent of the disease, based on the CT characteristics of inflammation 
or thickening? If yes, did it correlate with the extent of the disease as evaluated by the 
colonoscopic examination done at an earlier occasion.  
 
4. Were the features of the activity of the disease seen in all the segments of colon as per the 
disease extent? O r the activity of the disease was limited to only some segments and in some 
segments the activity either could not be assessed or did not show activity.  
 
5. Although, so many characteristics of activity were seen, all of them may not be used in the 
scoring  system, the score given to each characteristic should ideally be derived based their 
coefficient based on regression analysis.  
 
6. It will be appropriate, if authors could classify the extent of the disease based on the 
Montreal classification (E1, E2, E3 ) which is most standard method of describing the extent 
of the disease.  
 
7. How was colonic stricture differentiated from the undistestended segments, since, stricture 
formation is distinctly uncommon in patients with UC. If stricture is present, one shou ld 
always suspect malignancy.  
 
8. The submucosal bubble may not always signify crypt abscesses (page 11, line 34), and 
submucosal ulcers. In UC, especially severe UC, there is diffuse ulceration of the colonic 
mucosa, however the CT films show only occasional submucosal bubbles. The ulc ers in UC 
mostly affect mucosal layer and only uncommonly submucosal layer. Furthermore, crypt 
abscess is a microscopic finding, likely not to be appreciated on macroscopic examination, 
either by radiological imaging or even high definition endoscopic imag ing.  
Are the methods appropriate and well descr ibed?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
No 
 
Are the conclusions drawn adequately sup ported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, pleas e specify what aspects require further  
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some language corrections before being publish ed 
 
  
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation that may in any way g ain or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose  
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the  
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds  or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I  declare that I have no competing interests' 
below.  If your reply is yes to any, please give details below.  
 
I declare no conflict of interest  
 
I agree to the open peer review policy of the journal. I understand that my name will be included  
on my report to the authors and, if the manuscript is accepted for publication, my named report  
including any attachments I upload will be posted on the website along with the authors'  
responses. I agree for my report to be made available under an Open Access Creative Com mons  
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments  
which I do not wish to be included in my named report can be included as confidential comments  
to the editors, which will not be published.  
 
I agree to the open  peer review policy of the journal  
Reviewer ’s report  
 
Title: CT Enterography Score: A Potential Predictor for Severity Assessment of Active 
Ulcerative Colitis  
 
Version: 0 Date: 23 Jan 2018  
 
Reviewer: Govind Makharia  
 
Reviewer's report:  
 
Please include all comments for the authors in this box rather than uploading your report as an 
attachment. Please only uploa d as attachments annotated versions of manuscripts, graphs, 
supporting materials or other aspects of your report which cannot be included in a text format.  
Please overwrite this text when adding your comments to the authors.  
In the present study, the auth ors have reported the utility of CT enterography in evaluating the 
severity of the activity of ulcerative colitis. The authors have demonstrated certain features on 
CT enterography. The images are of very good quality.  
 
Comments  
1. Of all patients, how m any patients had adequate distension of the entire colon? How was the 
adequacy of distension ascertained?  
 
2. It is really difficult to get the recto -sigmoid  
 
3. Could you assess the extent of the disease, based on the CT characteristics of inflammation 
or thickening? If yes, did it correlate with the extent of the disease as evaluated by the 
colonoscopic examination done at an earlier occasion.  
 
4. Were the features of the activity of the disease seen in all the segments of colon as per the 
disease extent? O r the activity of the disease was limited to only some segments and in some 
segments the activity either could not be assessed or did not show activity.  
 
5. Although, so many characteristics of activity were seen, all of them may not be used in the 
scoring  system, the score given to each characteristic should ideally be derived based their 
coefficient based on regression analysis.  
 
6. It will be appropriate, if authors could classify the extent of the disease based on the 
Montreal classification (E1, E2, E3 ) which is most standard method of describing the extent 
of the disease.  
 
7. How was colonic stricture differentiated from the undistestended segments, since, stricture 
formation is distinctly uncommon in patients with UC. If stricture is present, one shou ld 
always suspect malignancy.  
 
8. The submucosal bubble may not always signify crypt abscesses (page 11, line 34), and 
submucosal ulcers. In UC, especially severe UC, there is diffuse ulceration of the colonic 
mucosa, however the CT films show only occasional submucosal bubbles. The ulc ers in UC 
mostly affect mucosal layer and only uncommonly submucosal layer. Furthermore, crypt 
abscess is a microscopic finding, likely not to be appreciated on macroscopic examination, 
either by radiological imaging or even high definition endoscopic imag ing.  
Are the methods appropriate and well descr ibed?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
No 
 
Are the conclusions drawn adequately sup ported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, pleas e specify what aspects require further  
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some language corrections before being publish ed 
 
  
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation that may in any way g ain or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose  
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the  
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds  or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I  declare that I have no competing interests' 
below.  If your reply is yes to any, please give details below.  
 
I declare no conflict of interest  
 
I agree to the open peer review policy of the journal. I understand that my name will be included  
on my report to the authors and, if the manuscript is accepted for publication, my named report  
including any attachments I upload will be posted on the website along with the authors'  
responses. I agree for my report to be made available under an Open Access Creative Com mons  
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments  
which I do not wish to be included in my named report can be included as confidential comments  
to the editors, which will not be published.  
 
I agree to the open  peer review policy of the journal  
Please review this paper.
user
Reviewer ’s report  
 
Title: CT Enterography Score: A Potential Predictor for Severity Assessment of Active 
Ulcerative Colitis  
 
Version: 0 Date: 23 Jan 2018  
 
Reviewer: Govind Makharia  
 
Reviewer's report:  
 
Please include all comments for the authors in this box rather than uploading your report as an 
attachment. Please only uploa d as attachments annotated versions of manuscripts, graphs, 
supporting materials or other aspects of your report which cannot be included in a text format.  
Please overwrite this text when adding your comments to the authors.  
In the present study, the auth ors have reported the utility of CT enterography in evaluating the 
severity of the activity of ulcerative colitis. The authors have demonstrated certain features on 
CT enterography. The images are of very good quality.  
 
Comments  
1. Of all patients, how m any patients had adequate distension of the entire colon? How was the 
adequacy of distension ascertained?  
 
2. It is really difficult to get the recto -sigmoid  
 
3. Could you assess the extent of the disease, based on the CT characteristics of inflammation 
or thickening? If yes, did it correlate with the extent of the disease as evaluated by the 
colonoscopic examination done at an earlier occasion.  
 
4. Were the features of the activity of the disease seen in all the segments of colon as per the 
disease extent? O r the activity of the disease was limited to only some segments and in some 
segments the activity either could not be assessed or did not show activity.  
 
5. Although, so many characteristics of activity were seen, all of them may not be used in the 
scoring  system, the score given to each characteristic should ideally be derived based their 
coefficient based on regression analysis.  
 
6. It will be appropriate, if authors could classify the extent of the disease based on the 
Montreal classification (E1, E2, E3 ) which is most standard method of describing the extent 
of the disease.  
 
7. How was colonic stricture differentiated from the undistestended segments, since, stricture 
formation is distinctly uncommon in patients with UC. If stricture is present, one shou ld 
always suspect malignancy.  
 
8. The submucosal bubble may not always signify crypt abscesses (page 11, line 34), and 
submucosal ulcers. In UC, especially severe UC, there is diffuse ulceration of the colonic 
mucosa, however the CT films show only occasional submucosal bubbles. The ulc ers in UC 
mostly affect mucosal layer and only uncommonly submucosal layer. Furthermore, crypt 
abscess is a microscopic finding, likely not to be appreciated on macroscopic examination, 
either by radiological imaging or even high definition endoscopic imag ing.  
Are the methods appropriate and well descr ibed?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
No 
 
Are the conclusions drawn adequately sup ported by the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an  
additional statistical review?  
If an additional statistical review is recommended, pleas e specify what aspects require further  
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some language corrections before being publish ed 
 
  
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an  
organisation that may in any way g ain or lose financially from the publication of this  
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose  
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the  
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds  or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I  declare that I have no competing interests' 
below.  If your reply is yes to any, please give details below.  
 
I declare no conflict of interest  
 
I agree to the open peer review policy of the journal. I understand that my name will be included  
on my report to the authors and, if the manuscript is accepted for publication, my named report  
including any attachments I upload will be posted on the website along with the authors'  
responses. I agree for my report to be made available under an Open Access Creative Com mons  
CC-BY license ( http://creativecommons.org/licenses/by/4.0/ ). I understand that any comments  
which I do not wish to be included in my named report can be included as confidential comments  
to the editors, which will not be published.  
 
I agree to the open  peer review policy of the journal  
assistant