Intestinal ultrasound as a non-invasive tool to monitor inflammatory bowel disease activity and guide clinical decision making

Abstract

Intestinal ultrasound (IUS) is a non-invasive, real-time, cross-sectional imaging tool that can be used at the point-of-care to assess disease activity in patients with Crohn’s disease or ulcerative colitis. IUS promotes quick and impactful treatment decisions that can modify disease progression and enhance patient compliance. This review will summarize the technical aspects of IUS, the evidence to support the use of IUS in disease activity monitoring, the comparison of IUS to current standard of care monitoring modalities such as colonoscopy and calprotectin, and the optimal positioning of IUS in a tight-control monitoring strategy.

Novelties and Perspectives of Intestinal Ultrasound in the Personalised Management of Patients with Inflammatory Bowel Diseases—A Systematic Review

“…A few attempts have been made to enhance the utility of BWS, mesenteric fat hypertrophy and lymph node enlargement, but they are less frequent and more subjective [104,105]. A plethora of ultrasonographic scores obtained by combining these parameters have been imagined by numerous authors and showed various accuracies for disease activity evaluation [106,107]. However, there are currently no meta-analyses or systematic reviews comparing them to determine which ones are the most appropriate for clinical settings.…”

“…Special groups of patients are represented by pregnant women and children, in whom irradiating methods (CTE) are contraindicated as they pose great risks for the foetus and the underage population [110]. In both groups, MRE is difficult to obtain, either due to gantry dimensions in female patients with voluminous abdomen or due to lack of cooperation in paediatric patients [107].…”

Discontinuation of therapy in inflammatory bowel disease: Current views

“…There is considerable anticipation regarding the role of intestinal ultrasound as a convenient imaging method. Until now, intestinal ultrasound has been established as a cross-sectional imaging tool, accurate in assessing IBD activity in real time[ 64 ]. It not only positively impacts patient compliance but also aids in quick clinical decision-making[ 64 ].…”

“…Until now, intestinal ultrasound has been established as a cross-sectional imaging tool, accurate in assessing IBD activity in real time[ 64 ]. It not only positively impacts patient compliance but also aids in quick clinical decision-making[ 64 ]. It is worth highlighting the possibility of machine learning models that could be used for designing suitable algorithms for assessing the severity of the disease and the possibility of relapse.…”

Intestinal Ultrasound Is the Ideal Patient-Centric, Point-of-Care Tool for Clinical Decision Making in the Inflammatory Bowel Disease Practice

“…IUS is a noninvasive, point-of-care, real-time cross-sectional imaging modality that provides accurate disease activity assessment in patients with IBD without the need for fasting, bowel preparation, or contrast. 9 Although IUS may be the key to improving remission rates further, evidence to inform its optimal positioning and support its clinical utility is still limited, and additional understanding of its ability to guide clinical decision making in the absence of additional testing is needed. 10–12 …”