Title: Ultrasonographic scores for ileal Crohn’s disease assessment: better, worse or the same
as contrast-enhanced ultrasound?
Version: 1 Date: 06 Feb 2022
Reviewer's report:
Dear authors,
thank you for the opportunity to review your manuscript.
The manuscript reports  retrospective data on 50 patients with ileocoecal Crohn's Disease, who
were evaluated with two new ultrasound-based scores, advanced CEUS analyses and endoscopy
using standardized scores to define disease activity.
CEUS and endoscopy showed a good agreement (AUC for CEUS 0.8), whereas the two US-
scores based on conventional ultrasound did not reach a meaningful correlation with endoscopic
assessment.
General impression: This is an interesting work that can enrich the knowledge of IBD
diagnostics. However, the retrospective approach requires careful data assessment and
interpretation.
The interval between endoscopy and US was one month and the statement that medication was
not modified in this period requires explanation, especially in cases with active disease.
Moreover, endoscopy is also not a perfect standard, so information on examiner qualification
would be useful. Also, disease activity is usually assessed with biopsies, but the report does not
comment on histology and does not provide any analysis of histological activity.
Overall, the limitations require more attention and need clear statements in the discussion.
Detailed comments:
The title suggests that CEUS is a reference standard for assessing CD. CEUS may be helpful,
but is not yet a gold standard. Consider changing the title to "comparison with CEUS".
Please give information on baseline characteristics and IBD activity in the abstract. Some
figures/numbers of the results in the abstract require definitions.
Methods: Please define "inadequate ultrasonographic profile". Is this a source of bias, especially
in patients with highly active disease? Who performed the endoscopy (Blinded to ultrasound
results? Experts or novices?)?
Results: Gender distribution: 54% is allmost an equal distribution.
Many important data are just presented by mean and SD. Was there always a normal distribution?
Consider presenting subgroups, and medians / ranges if appropriate. This may be more
informative.
CEUS: Where there any adverse events? If not, please state so.
Discussion: Quite long and redundant in some places. Can be shortened, but enriched by
discussion of limitations (see above).
Title: Ultrasonographic scores for ileal Crohn’s disease assessment: better, worse or the same
as contrast-enhanced ultrasound?
Version: 1 Date: 06 Feb 2022
Reviewer's report:
Dear authors,
thank you for the opportunity to review your manuscript.
The manuscript reports  retrospective data on 50 patients with ileocoecal Crohn's Disease, who
were evaluated with two new ultrasound-based scores, advanced CEUS analyses and endoscopy
using standardized scores to define disease activity.
CEUS and endoscopy showed a good agreement (AUC for CEUS 0.8), whereas the two US-
scores based on conventional ultrasound did not reach a meaningful correlation with endoscopic
assessment.
General impression: This is an interesting work that can enrich the knowledge of IBD
diagnostics. However, the retrospective approach requires careful data assessment and
interpretation.
The interval between endoscopy and US was one month and the statement that medication was
not modified in this period requires explanation, especially in cases with active disease.
Moreover, endoscopy is also not a perfect standard, so information on examiner qualification
would be useful. Also, disease activity is usually assessed with biopsies, but the report does not
comment on histology and does not provide any analysis of histological activity.
Overall, the limitations require more attention and need clear statements in the discussion.
Detailed comments:
The title suggests that CEUS is a reference standard for assessing CD. CEUS may be helpful,
but is not yet a gold standard. Consider changing the title to "comparison with CEUS".
Please give information on baseline characteristics and IBD activity in the abstract. Some
figures/numbers of the results in the abstract require definitions.
Methods: Please define "inadequate ultrasonographic profile". Is this a source of bias, especially
in patients with highly active disease? Who performed the endoscopy (Blinded to ultrasound
results? Experts or novices?)?
Results: Gender distribution: 54% is allmost an equal distribution.
Many important data are just presented by mean and SD. Was there always a normal distribution?
Consider presenting subgroups, and medians / ranges if appropriate. This may be more
informative.
CEUS: Where there any adverse events? If not, please state so.
Discussion: Quite long and redundant in some places. Can be shortened, but enriched by
discussion of limitations (see above).
Please review this paper.
user
Title: Ultrasonographic scores for ileal Crohn’s disease assessment: better, worse or the same
as contrast-enhanced ultrasound?
Version: 1 Date: 06 Feb 2022
Reviewer's report:
Dear authors,
thank you for the opportunity to review your manuscript.
The manuscript reports  retrospective data on 50 patients with ileocoecal Crohn's Disease, who
were evaluated with two new ultrasound-based scores, advanced CEUS analyses and endoscopy
using standardized scores to define disease activity.
CEUS and endoscopy showed a good agreement (AUC for CEUS 0.8), whereas the two US-
scores based on conventional ultrasound did not reach a meaningful correlation with endoscopic
assessment.
General impression: This is an interesting work that can enrich the knowledge of IBD
diagnostics. However, the retrospective approach requires careful data assessment and
interpretation.
The interval between endoscopy and US was one month and the statement that medication was
not modified in this period requires explanation, especially in cases with active disease.
Moreover, endoscopy is also not a perfect standard, so information on examiner qualification
would be useful. Also, disease activity is usually assessed with biopsies, but the report does not
comment on histology and does not provide any analysis of histological activity.
Overall, the limitations require more attention and need clear statements in the discussion.
Detailed comments:
The title suggests that CEUS is a reference standard for assessing CD. CEUS may be helpful,
but is not yet a gold standard. Consider changing the title to "comparison with CEUS".
Please give information on baseline characteristics and IBD activity in the abstract. Some
figures/numbers of the results in the abstract require definitions.
Methods: Please define "inadequate ultrasonographic profile". Is this a source of bias, especially
in patients with highly active disease? Who performed the endoscopy (Blinded to ultrasound
results? Experts or novices?)?
Results: Gender distribution: 54% is allmost an equal distribution.
Many important data are just presented by mean and SD. Was there always a normal distribution?
Consider presenting subgroups, and medians / ranges if appropriate. This may be more
informative.
CEUS: Where there any adverse events? If not, please state so.
Discussion: Quite long and redundant in some places. Can be shortened, but enriched by
discussion of limitations (see above).
assistant