“libenter homines id quod volunt credunt.” (Men willingly believe what they wish). Gaius Julius Caesar, De Bello Gallico, Book 3.

Imaging methods in inflammatory bowel disease (IBD) are used to serve two purposes: firstly, to establish the diagnosis in suspected IBD, and secondly, to gain information for correct management in known cases of IBD. To date, colonoscopy with biopsy remains the method of first choice to diagnose IBD. Discrete morphological alterations such as erythema, oedema, and granularity of the mucosa, small erosions, or aphthous ulcers can be reliably depicted by videoendoscopy and subsequently confirmed by histopathology. In established IBD however, patients and physicians are reluctant to perform repeated colonoscopies because of the invasive nature of the test and the inability to assess extraluminal complications in Crohn’s disease, including enteric fistulae or abscesses. For this purpose, cross sectional imaging methods have gained increasing importance in the past years.¹ The question arises as to whether advancement in technology (multislice computed tomography or magnetic resonance imaging (MRI) scans) may also enable assessment of the mucosal inflammation in IBD, thereby potentially replacing endoscopy and biopsy at some point in the future.

This question was approached by two independent groups from Germany in this issue of Gut.^2,3 The group from Essen² reported on a two phase investigation …