{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T08:42:52Z","timestamp":1792226572159,"version":"4.4.0"},"reference-count":30,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T00:00:00Z","timestamp":1792195200000},"content-version":"vor","delay-in-days":16,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The Crohn's Anal Fistula Quality of Life (CAF\u2010QoL) questionnaire is the first disease\u2010specific patient\u2010reported outcome measure (PROM) for perianal fistulising Crohn's disease (pfCD). However, validation against objective measures of disease burden is limited. We evaluated the relationship between CAF\u2010QoL and quantitative MRI fistula volume to determine whether MRI\u2010derived disease burden supports the construct validity of this PROM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Adults with pfCD were prospectively recruited from a tertiary referral centre. Patients underwent pelvic MRI and completed CAF\u2010QoL within 3 months of imaging. MRI fistula volume was independently quantified by two radiologists using ITK\u2010SNAP, with concurrent scoring of the Van Assche Index (VAI). Clinical disease activity was assessed using the Perianal Disease Activity Index (PDAI). Associations between MRI measures, CAF\u2010QoL and PDAI were evaluated cross\u2010sectionally and longitudinally.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Thirty\u2010eight patients were included. MRI fistula volume correlated with both CAF\u2010QoL (\n                      <jats:italic>\u03c1<\/jats:italic>\n                      \u2009=\u20090.40,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03) and PDAI (\n                      <jats:italic>\u03c1<\/jats:italic>\n                      \u2009=\u20090.59,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Patients achieving CAF\u2010QoL remission had significantly smaller fistula volumes than those with active disease (279 vs. 965\u2009mm\n                      <jats:sup>3<\/jats:sup>\n                      ,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.04). Longitudinal changes in fistula volume correlated with changes in CAF\u2010QoL (\n                      <jats:italic>\u03c1<\/jats:italic>\n                      \u2009=\u20090.61,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02) and PDAI (\n                      <jats:italic>\u03c1<\/jats:italic>\n                      \u2009=\u20090.74,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009\u2264\u20090.01). There was no significant association between the VAI and either CAF\u2010QoL or PDAI. Inter\u2010observer agreement for MRI volume measurement was excellent (ICC\u2009=\u20090.995).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Quantitative MRI fistula volume provides objective construct validation of the CAF\u2010QoL questionnaire and captures clinically meaningful disease burden in pfCD. Combined assessment of MRI fistula volume and CAF\u2010QoL may provide complementary imaging and patient\u2010reported endpoints for clinical practice and future therapeutic trials. Larger prospective multicentre studies are warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/codi.70653","type":"journal-article","created":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T08:25:46Z","timestamp":1792225546000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Objective validation of the Crohn's Anal Fistula Quality of Life questionnaire using quantitative\n                    <scp>MRI<\/scp>\n                    fistula volume in perianal fistulising Crohn's disease"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0852-5931","authenticated-orcid":false,"given":"Easan","family":"Anand","sequence":"first","affiliation":[{"name":"St Mark's, the National Bowel Hospital, Central Middlesex  London UK"},{"name":"Department of Surgery &amp; Cancer Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theo","family":"Pelly","sequence":"additional","affiliation":[{"name":"St Mark's, the National Bowel Hospital, Central Middlesex  London UK"},{"name":"Department of Surgery &amp; Cancer Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1745-0238","authenticated-orcid":false,"given":"Uday","family":"Patel","sequence":"additional","affiliation":[{"name":"St Mark's, the National Bowel Hospital, Central Middlesex  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7878-4800","authenticated-orcid":false,"given":"Rory","family":"Callan","sequence":"additional","affiliation":[{"name":"St Mark's, the National Bowel Hospital, Central Middlesex  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reshma","family":"Kanani","sequence":"additional","affiliation":[{"name":"St Mark's, the National Bowel Hospital, Central Middlesex  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ailsa","family":"Hart","sequence":"additional","affiliation":[{"name":"St Mark's, the National Bowel Hospital, Central Middlesex  London UK"},{"name":"Department of Metabolism, Digestion &amp; Reproduction Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phil","family":"Tozer","sequence":"additional","affiliation":[{"name":"St Mark's, the National Bowel Hospital, Central Middlesex  London UK"},{"name":"Department of Surgery &amp; Cancer Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phillip","family":"Lung","sequence":"additional","affiliation":[{"name":"St Mark's, the National Bowel Hospital, Central Middlesex  London UK"},{"name":"Department of Surgery &amp; Cancer Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,17]]},"reference":[{"key":"e_1_2_15_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12955\u2010020\u201001622\u20107"},{"key":"e_1_2_15_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/crocol\/otad036"},{"issue":"1","key":"e_1_2_15_4_1","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1097\/00004836-199501000-00008","article-title":"Usual therapy improves perianal Crohn's disease as measured by a new disease activity index. McMaster IBD study group","volume":"20","author":"Irvine EJ","year":"1995","journal-title":"J Clin Gastroenterol"},{"key":"e_1_2_15_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199905063401804"},{"key":"e_1_2_15_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl\u20102019\u2010320553"},{"key":"e_1_2_15_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2025.12.016"},{"key":"e_1_2_15_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2025.11.005"},{"key":"e_1_2_15_9_1","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000003906"},{"key":"e_1_2_15_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/ecco\u2010jcc\/jjaf231.693"},{"key":"e_1_2_15_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/ecco\u2010jcc\/jjaf106"},{"key":"e_1_2_15_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/ecco\u2010jcc\/jjaf216"},{"key":"e_1_2_15_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinimag.2019.10.007"},{"key":"e_1_2_15_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/ueg2.70003"},{"key":"e_1_2_15_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/1756284818793609"},{"key":"e_1_2_15_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/ecco\u2010jcc\/jjag018"},{"key":"e_1_2_15_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(07)61602\u2010X"},{"key":"e_1_2_15_18_1","doi-asserted-by":"publisher","DOI":"10.3109\/07853890109002087"},{"key":"e_1_2_15_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/flgastro\u20102025\u2010103198"},{"key":"e_1_2_15_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468\u20101253(22)00007\u20103"},{"key":"e_1_2_15_21_1","doi-asserted-by":"publisher","DOI":"10.1093\/crocol\/otaf015"},{"key":"e_1_2_15_22_1","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics16010072"},{"key":"e_1_2_15_23_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12955\u2010021\u201001724\u2010w"},{"key":"e_1_2_15_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0016\u20105085(24)03851\u20104"},{"key":"e_1_2_15_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00330\u2010020\u201006826\u20105"},{"key":"e_1_2_15_26_1","doi-asserted-by":"publisher","DOI":"10.1093\/ecco\u2010jcc\/jjae089"},{"key":"e_1_2_15_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2025.02.009"},{"key":"e_1_2_15_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2023.102045"},{"key":"e_1_2_15_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468\u20101253(22)00088\u20107"},{"key":"e_1_2_15_30_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10151\u2010024\u201003094\u2010z"},{"key":"e_1_2_15_31_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.c5146"}],"container-title":["Colorectal Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/codi.70653","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/codi.70653","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/codi.70653","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T08:25:47Z","timestamp":1792225547000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/codi.70653"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10]]},"references-count":30,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1111\/codi.70653"],"URL":"https:\/\/doi.org\/10.1111\/codi.70653","archive":["Portico"],"relation":{},"ISSN":["1462-8910","1463-1318"],"issn-type":[{"value":"1462-8910","type":"print"},{"value":"1463-1318","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10]]},"assertion":[{"value":"2026-07-14","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-06","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-17","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70653"}}