Jack H, Ahmadzade M, Horn Jr GL, Ghasemi-Rad M. Dual-energy computed tomography quantification of creeping fat in Crohn’s disease: A new radiologic biomarker for transmural disease monitoring. World J Radiol 2026; 18(8): 124486 [DOI: 10.4329/wjr.124486]
Corresponding Author of This Article
Mohammad Ghasemi-Rad, MD, Associate Professor, Department of Radiology, Section of Vascular and Interventional Radiology, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX 77030, United States. mohammad.ghasemirad@bcm.edu
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Radiology, Nuclear Medicine & Medical Imaging
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editorial
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Jack H, Ahmadzade M, Horn Jr GL, Ghasemi-Rad M. Dual-energy computed tomography quantification of creeping fat in Crohn’s disease: A new radiologic biomarker for transmural disease monitoring. World J Radiol 2026; 18(8): 124486 [DOI: 10.4329/wjr.124486]
World J Radiol. Aug 28, 2026; 18(8): 124486 Published online Aug 28, 2026. doi: 10.4329/wjr.124486
Dual-energy computed tomography quantification of creeping fat in Crohn’s disease: A new radiologic biomarker for transmural disease monitoring
Hunter Jack, Mohadese Ahmadzade, Gary Lloyd Horn Jr, Mohammad Ghasemi-Rad
Hunter Jack, Gary Lloyd Horn Jr, Department of Radiology, Baylor College of Medicine, Houston, TX 77030, United States
Mohadese Ahmadzade, Mohammad Ghasemi-Rad, Department of Radiology, Section of Vascular and Interventional Radiology, Baylor College of Medicine, Houston, TX 77030, United States
Author contributions: Jack H and Ahmadzade M performed the literature review and drafted the manuscript; Horn GL Jr critically revised the manuscript for important intellectual content; Ghasemi-Rad M conceived and supervised the editorial; and all authors read and approved the final version.
AI contribution statement: AI tools, specifically Claude (Anthropic), were used to assist with literature/reference verification, formatting, and language editing during manuscript revision. No AI tool was used to generate original research data, interpret results, or formulate scientific conclusions. All AI-assisted content was critically reviewed and revised by the authors, who take full responsibility for the accuracy, originality, and integrity of the manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Mohammad Ghasemi-Rad, MD, Associate Professor, Department of Radiology, Section of Vascular and Interventional Radiology, Baylor College of Medicine, 1 Baylor Plaza, Houston, TX 77030, United States. mohammad.ghasemirad@bcm.edu
Received: June 17, 2026 Revised: July 23, 2026 Accepted: August 5, 2026 Published online: August 28, 2026 Processing time: 72 Days and 2.9 Hours
Abstract
Accurate, noninvasive assessment of disease activity remains one of the central challenges in the management of Crohn’s disease (CD). The study by Dong et al in World Journal of Radiology represents a meaningful advance in this effort, demonstrating that dual-energy computed tomography with the material decomposition algorithm can reliably quantify intestinal creeping fat (CrF), a pathological hallmark of CD, and that this measurement correlates robustly with clinical, endoscopic, histological, and molecular indicators of disease activity. Notably, CrF volume tracked not only inflammatory burden and fibrosis, but also the expression of peroxisome proliferator-activated receptor gamma 2 and occludin, implicating CrF in both adipogenesis and intestinal barrier dysfunction. Crucially, CrF remained elevated during clinical remission, underscoring its potential as a more sensitive marker of subclinical disease persistence than conventional activity indices alone. As the field continues to seek non-invasive surrogates for mucosal healing and histological remission, dual-energy computed tomography-based CrF quantification emerges as a promising, clinically accessible tool. With further validation in larger, multicenter cohorts, this approach could meaningfully reshape how we monitor disease activity, evaluate treatment response, and predict disease course in CD.
Core Tip: Dual-energy computed tomography with multi-material decomposition allows objective quantification of creeping fat in Crohn’s disease. This radiologic marker correlates with clinical, endoscopic, histologic, and molecular indices of disease activity and may help assess transmural and mesenteric disease beyond mucosal healing.
