Patients' Attitudes to Magnetic Resonance Imaging in Perianal Fistulizing Crohn’s Disease: A Global Survey

Abstract

Background: There is limited patient involvement in radiological research for perianal fistulizing Crohn’s disease (pfCD), despite magnetic resonance imaging (MRI)’s critical role in diagnosis and management. Patient and public involvement is essential for aligning research with patient priorities. This study aimed to gather patient perspectives on the use of MRI in pfCD. Methods: A mixed-methods approach was used, following Guidance for Reporting Involvement of Patients and the Public (GRIPP2) guidelines. An online survey, co-developed with a patient representative, included open and closed questions on MRI experiences, advantages, challenges, and the potential for Artificial Intelligence (AI)-generated reports. This was followed by a virtual session for further exploration of patient views. Thematic analysis was conducted on the data. Results: Forty-seven patients with Crohn’s disease (37 with pfCD) from 6 countries participated, with 28/37 (76%) completing the survey. Key themes included patient expectations for MRI, preferences for scan intervals, and report content. Most (93%) wanted MRI reports to compare with previous scans, highlighting fistula changes and new abscesses. A majority (57%) preferred MRI scans annually when well, and more frequently after surgery (64.3% preferred scans at 3 months). Emotional relief was associated with MRI improvements, though access to services and report clarity remained challenging. Interest in AI-generated reports was expressed if clearly explained and validated by professionals. Conclusions: This is the first study exploring patient views on MRI use in pfCD, emphasizing the need for patient-centred MRI reporting and clearer communication. Future work should enhance patient access and validate AI-generated MRI reports.