Diagnostic Accuracy of Non-Invasive Imaging for Detection of Colonic Inflammation in Patients with Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis

Alshammari, Meshari T; Stevenson, Rebecca; Abdul-Aema, Buraq; Zou, Guangyong; Jairath, Vipul; Radford, Shellie; Marciani, Luca; Moran, Gordon W

doi:10.3390/diagnostics11101926

Cited by 13 publications

(8 citation statements)

References 55 publications

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“…However, once disease location and phenotype are established, in many patients, there is an equipoise between MRE and small bowel ultrasound in subsequent disease follow-up and monitoring. SBUS has been shown to be equally accurate for evaluating enteric disease,18–23 cheaper, quicker, better tolerated and, most importantly, preferred by patients 10 24–27. Despite this, US is not widely implemented for CD in the UK, for reasons we do not fully understand.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound use to assess Crohn’s disease in the UK: a survey of British Society of Gastroenterology Inflammatory Bowel Disease Group members

Radford

Taylor²,

Moran

2022

Frontline Gastroenterol

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BackgroundSmall bowel ultrasound has very good diagnostic accuracy for disease extent, presence and activity in Crohn’s Disease, is well tolerated by patients and is cheaper when compared with MRI. However, uptake of ultrasound in the UK is limited.MethodsAn online survey to assess the current usage of ultrasound throughout the UK was undertaken by BSG IBD group members between 9/06/2021- 25/06/2021. Responses were anonymous.Results103 responses were included in the data analysis. Responses came from 66 different NHS trusts from 14 different regions of the UK. All respondents reported that they currently have an MRI service for Crohn’s disease, whereas only 31 had an ultrasound service. Average time for results to be reported for MRI scans was reported as between 4– and 6 weeks, with a range of 2 days to 28 weeks. The average time for an ultrasound to be reported was stated as 1–4 weeks, with a range of 0–8 weeks. There was disparity between the reported confidence of clinicians making clinical decisions when using ultrasound compared to MRI. Of those respondents who did not have access to an ultrasound service, 72 stated that they would be interested in developing an ultrasound service.ConclusionThere is an appetite for the uptake of ultrasound in the UK for assessment of Crohn’s disease, however, there remains a significant number of UK centres with little or no access to an ultrasound service. Further research is necessary to understand why this is the case.

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Section: Discussionmentioning

confidence: 99%

Ultrasound use to assess Crohn’s disease in the UK: a survey of British Society of Gastroenterology Inflammatory Bowel Disease Group members

Radford

Taylor²,

Moran

2022

Frontline Gastroenterol

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“…For IBD, FC with a cutoff of 50 µg/g presented the highest sensitivity of 0.92 (0.90-0.94) (42), and MRE showed the highest specificity of 0.93 (0.90-0.95) (30). Besides, other radiological examinations [US, leukocyte scintigraphy (LS), and CT] all performed well with balanced sensitivity and specificity (6,30,43,56,59). However, other biomarkers (CRP and FL) were not as good as radiological examinations (27).…”

Section: Mixed Populationmentioning

confidence: 98%

Diagnostic Utility of Non-invasive Tests for Inflammatory Bowel Disease: An Umbrella Review

et al. 2022

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BackgroundThis study aims to consolidate evidence from published systematic reviews and meta-analyses evaluating the diagnostic performances of non-invasive tests for inflammatory bowel disease (IBD) in various clinical conditions and age groups.MethodsTwo independent reviewers systematically identified and appraised systematic reviews and meta-analyses assessing the diagnostic utility of non-invasive tests for IBD. Each association was categorized as adults, children, and mixed population, based on the age ranges of patients included in the primary studies. We classified clinical scenarios into diagnosis, activity assessment, and predicting recurrence.ResultsIn total, 106 assessments from 43 reviews were included, with 17 non-invasive tests. Fecal calprotectin (FC) and fecal lactoferrin (FL) were the most sensitive for distinguishing IBD from non-IBD. However, anti-neutrophil cytoplasmic antibodies (ANCA) and FL were the most specific for it. FC and FL were the most sensitive and specific tests, respectively, to distinguish IBD from irritable bowel syndrome (IBS). Anti-Saccharomyces cerevisiae antibodies (ASCA), IgA, were the best test to distinguish Crohn’s disease (CD) from ulcerative colitis (UC). Interferon-γ release assay was the best test to distinguish CD from intestinal tuberculosis (ITB). Ultrasound (US) and magnetic resonance enterography (MRE) were both sensitive and specific for disease activity, along with the high sensitivity of FC. Small intestine contrast ultrasonography (SICUS) had the highest sensitivity, and FC had the highest specificity for operative CD recurrence.ConclusionIn this umbrella review, we summarized the diagnostic performance of non-invasive tests for IBD in various clinical conditions and age groups. Clinicians can use the suggested non-invasive test depending on the appropriate clinical situation in IBD patients.

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“…A recent meta-analysis reported that the specificity of US and MRI diagnostic modalities to predict active disease in patients with established or suspected IBD was excellent (91%) when using colonoscopy as the gold standard 26. This indicates there is great ability for these non-invasive tools to distinguish disease-active from disease-free patients.…”

Section: Large Bowelmentioning

confidence: 99%

Imaging in inflammatory bowel disease: current and future perspectives

Shaban

Hoad

Naim

et al. 2022

Frontline Gastroenterol

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The use of cross-sectional imaging and ultrasonography has long complemented endoscopic assessment of inflammatory bowel disease (IBD). Clinical symptoms alone are often not enough to assess disease activity, so a reliance on non-invasive techniques is essential. In this paper, we aim to examine the current use of radiological modalities in aiding the management of patients with IBD. We focus on the various sections of the gastrointestinal tract and how different modalities can aid in assessing current disease state and response to treatments. We also have a look at how newer sequences in cross-sectional imaging and ultrasonography can allow for better differentiation of disease activity (ie, fibrotic vs inflammatory) as well improve evaluation of small bowel, colonic and perianal disease. Furthermore, we examine how advanced image processing has the potential to allow radiology to be a surrogate for biomarkers. An example of this is explored when reviewing the ability of MR sequences to quantify visceral fat, which potentially plays a role in determining disease activity in Crohn’s disease. Lastly, we look into the expected role for artificial intelligence to be used as an adjunct to radiology to better improve IBD evaluation.

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Diagnostic Accuracy of Non-Invasive Imaging for Detection of Colonic Inflammation in Patients with Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis

Cited by 13 publications

References 55 publications

Ultrasound use to assess Crohn’s disease in the UK: a survey of British Society of Gastroenterology Inflammatory Bowel Disease Group members

Ultrasound use to assess Crohn’s disease in the UK: a survey of British Society of Gastroenterology Inflammatory Bowel Disease Group members

Diagnostic Utility of Non-invasive Tests for Inflammatory Bowel Disease: An Umbrella Review

Imaging in inflammatory bowel disease: current and future perspectives

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