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The quantitative morphology of the terminal ileum may predict treatment response.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Objective<\/jats:title>\n            <jats:p>We aimed to identify baseline qualitative and quantitative imaging features that are associated with clinical and radiologic treatment response in a large cohort of children with Crohn\u2019s disease.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Materials and methods<\/jats:title>\n            <jats:p>This was a retrospective study of the RISK cohort study in pediatric Crohn\u2019s disease. This multicenter study included 1,136 children &lt;18 years\u00a0from 28 sites in North America. Subjects enrolled with newly diagnosed Crohn\u2019s disease who underwent endoscopy with baseline and follow-up CT or MRI were considered for this study. Exclusion criteria were incomplete data or surgical resection prior to follow-up imaging. Imaging analysis included assessing a qualitative terminal ileum (TI) categorical score based on SAR-AGA consensus definitions ((1) normal, (2) inflammation only without luminal narrowing, (3) inflammation with luminal narrowing, or (4) stricture with pre-stenotic dilation\u2009\u22653\u00a0cm) and quantitative measurements (maximum bowel wall thickness and maximum\/minimum lumen diameter). Two endpoints were considered: (1) clinical response (off corticosteroids and quiescent Physician Global Assessment at follow-up imaging) and (2) CT and MRI response (follow-up imaging normalization). Multivariable logistic regression analyses were developed for each endpoint.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Ninety-six subjects were included. Clinical response endpoint was achieved in 38% (<jats:italic>n<\/jats:italic>=36) of participants, and imaging normalization was achieved in only 20% (<jats:italic>n<\/jats:italic>=19) of participants. Follow-up imaging showed disease progression in 24 (25%) patients, 7 (7%) of whom were radiologically normal at baseline (7%). A higher baseline TI categorical score was associated with lower odds of imaging normalization during follow-up (OR 0.4 [0.2, 0.8], <jats:italic>P<\/jats:italic>=0.009). Larger TI minimum lumen diameter (OR 1.1 [1.01, 1.3], <jats:italic>P<\/jats:italic>=0.04) and smaller maximum bowel wall thickness at baseline (OR 0.8 [0.6, 0.97], <jats:italic>P<\/jats:italic>=0.03) were associated with imaging normalization. There were no baseline imaging measurements associated with clinical response.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Baseline increased terminal ileal minimum lumen diameter and decreasing wall thickness were associated with imaging normalization at follow-up, but not clinical response.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Graphical Abstract<\/jats:title>\n          <\/jats:sec>","DOI":"10.1007\/s00247-025-06302-6","type":"journal-article","created":{"date-parts":[[2025,7,3]],"date-time":"2025-07-03T04:26:59Z","timestamp":1751516819000},"page":"1642-1651","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Baseline terminal ileal CT and MRI measurements are associated with imaging outcomes in pediatric Crohn\u2019s disease: a cohort study"],"prefix":"10.1007","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3403-5629","authenticated-orcid":false,"given":"Allison D.","family":"Ta","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan R.","family":"Dillman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicholas J.","family":"Ollberding","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yael","family":"Haberman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Baldassano","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Markowitz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony","family":"Otley","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jennifer L.","family":"Dotson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marian","family":"Pfefferkorn","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey S.","family":"Hyams","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melvin B.","family":"Heyman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandra C.","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joshua","family":"Noe","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott","family":"Snapper","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adina","family":"Alazraki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Subra","family":"Kugathasan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lee A.","family":"Denson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,7,3]]},"reference":[{"key":"6302_CR1","doi-asserted-by":"publisher","first-page":"849","DOI":"10.1002\/ibd.21801","volume":"18","author":"J Adler","year":"2012","unstructured":"Adler J, Punglia DR, Dillman JR et al (2012) Computed tomography enterography findings correlate with tissue inflammation, not fibrosis in resected small bowel Crohn\u2019s disease. 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Appropriate written informed consent was obtained in all cases from parents\/guardians or patients, and informed assent was provided as appropriate.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical considerations"}},{"value":"JRD: GE HealthCare, Motilent, Philips Healthcare.JH: Advisory Board Janssen, Abbvie, Lilly, Pfizer, Bristol Myers Squibb. Consultant Takeda.SS: Scientific advisory board participation for Pfizer, Pandion, Celgene, Lilly, Takeda, Cosmo Pharmaceuticals, Merck, Sonoma Biotherapeutics, and EcoR1. Grant support from Pfizer, Amgen Takeda, and Novartis. Consulting for Amgen, Kyverna, BMS, Merck, Third Rock, 89bio, GentiBio, and Apple Tree Life Sciences.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of interest"}}]}}