P242 Accuracy of Doppler transabdominal ultrasound in assessing disease severity and extent in IBD

Sagami, Shintaro; Taku, Keisei; Kanazawa, Tomoyuki; Aihara, Kanako; Morikubo, Hiromu; Ozaki, Ryo; Okabayashi, Shinji; Matsubayashi, Mao; Fuchigami, Ayako; Kiyohara, Hiroki; Nakano, Masaaki; Hibi, T

doi:10.1093/ecco-jcc/jjy222.366

Cited by 4 publications

(8 citation statements)

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“…Based on our previous experiences, we anticipated that the transabdominal ultrasound was incapable of detecting the bowel flow in the rectum. Therefore, we aimed to have ≥10 patients (20%) who have active inflammation with positive wall flow in the rectum to be able to demonstrate the superiority of transperineal ultrasound, which approximately requires ≥50 consecutive patients estimated by the previous database of ultrasound 6 . This number provides the ability to detect differences of 20% for the presence of bowel wall thickening and increase in Doppler signals among those with disease activity with an alpha risk of 0.05 and beta of 0.2.…”

Section: Methodsmentioning

confidence: 99%

“…Ultrasonography may be an ideal modality to address the limitations of both endoscopy and biomarkers. Transabdominal ultrasound has been reported to well correlate with the endoscopic severity of UC while it can visualise the extent and severity with very high patients' acceptability 4‐6 . Bowel wall thickening, loss of wall stratification and increased mucosal blood flow reflect the severity of inflammation and some scores have been developed to correlate with endoscopic severity 4,7,8 .…”

Section: Introductionmentioning

confidence: 99%

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Transperineal ultrasound predicts endoscopic and histological healing in ulcerative colitis

Sagami

Kobayashi

Aihara

et al. 2020

Aliment Pharmacol Ther

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Background:Transabdominal ultrasound is useful to assess inflammation in patients with ulcerative colitis (UC); however, the assessment of the rectum is challenging and a barrier for its widespread use. Aim:To evaluate if transperineal ultrasound is useful for predicting endoscopic and histological findings of the rectum in UC.Methods: Fifty-three consecutive adults with UC who required colonoscopy were included and transperineal ultrasound was performed in combination with transabdominal ultrasound within a week before or after colonoscopy with rectal biopsy.Mayo endoscopic subscore (MES) ≤1 was defined as endoscopic healing and Geboes score <2.1, Robarts histopathology index ≤6, and Nancy index ≤1 were defined as histological healing. Limberg score and bowel wall thickness were recorded with transperineal ultrasound. Faecal calprotectin was also measured. Results: Excellent correlation was confirmed between colonoscopy and transabdominal ultrasound in all segments except for the rectum. Rectal bowel wall thickness and Limberg score in transperineal ultrasound well correlated with rectal MES and histological indices. Bowel wall thickness ≤4 mm predicted endoscopic (Area under the curve [AUC] = 0.90) and histological (AUC = 0.87-0.89) healing. In multivariable logistic regression analysis, only bowel wall thickness in transperineal ultrasound was a significant independent predictor for rectal endoscopic and histologic healing (P < 0.05) and the predictability was better than faecal calprotectin. Conclusions: Transperineal ultrasound predicts endoscopic and histological healing of the rectum. The combination of transperineal ultrasound with transabdominal ultrasound visualises the entire colorectum and is an ideal modality for the treat-totarget strategy. Clinical Trials Registry number UMIN000033611

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Transperineal ultrasound predicts endoscopic and histological healing in ulcerative colitis

Sagami

Kobayashi

Aihara

et al. 2020

Aliment Pharmacol Ther

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“…The composite panel de nition of MH was de ned as the lack of ulceration on a single or combination of imaging examinations that met the following criteria: 1) CS/BAE/CE: SES-CD ulcer subscores of 0 or 1; 2) segment MaRIA score < 11 [7]; and 3) Limberg score of 0 or 1 [11].…”

Section: De Nition Of Mucosal Healing (Mh)mentioning

confidence: 99%

“…To rule out the in uence of colorectal lesions, the criteria for MH of the colon were de ned as no mucosal activity with the following scores: 1) CS/BAE/CE: SES-CD ulcer subscores of 0; 2) segment MaRIA score < 7 [7]; and 3) Limberg score of 0 or 1 [11] in the colorectum. Cases that did not meet the de nition of MH were considered to have small-bowel in ammation.…”

Section: De Nition Of Mucosal Healing (Mh)mentioning

confidence: 99%

“…A large proportion of small bowel lesions exist beyond the reach of ileocolonoscopy (CS); therefore, various modalities are used, such as balloon-assisted enteroscopy (BAE) [4,5], capsule endoscopy (CE) [6], magnetic resonance enterography (MRE) [7][8][9], and intestinal ultrasound (IUS) [10,11]. Overall, the diagnostic accuracy of these modalities seems to be comparable for small bowel CD [12][13][14].…”

Section: Introductionmentioning

confidence: 99%

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Optimal use of serum leucine-rich alpha-2 glycoprotein as a biomarker for small bowel lesions of Crohn's disease

Asonuma

Taku

Kikkawa

et al. 2022

Preprint

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A large proportion of small bowel lesions in Crohn’s disease (CD) may exist beyond the scope of ileocolonoscopy, suggesting the need for optimal biomarkers. This cross-sectional observational study prospectively measured C-reactive protein (CRP), faecal calprotectin (FC), and leucine-rich alpha-2 glycoprotein (LRG) in patients with quiescent CD who underwent imaging examinations (capsule or balloon-assisted endoscopy, magnetic resonance enterography, or intestinal ultrasound). Mucosal healing (MH) of the small bowel was defined as a lack of ulcers. Patients with a Crohn’s disease activity index of >220 and active colonic lesions were excluded. Seventy patients (29, MH; 41, small bowel inflammation) were analysed. The area under the curve (AUC) of CRP, FC, and LRG was 0.74 (95% confidence interval 0.60-0.86), 0.68 (0.52-0.80), and 0.75 (0.58-0.84), respectively. A cut-off of 16 μg/ml of LRG showed the highest positive predictive value of 0.95 with a specificity of 0.96, while the negative predictive value was the highest (0.71) with a sensitivity of 0.90 at a cut-off of 9 μg/ml. This suggests that LRG can accurately detect and/or exclude the small bowel lesions using two cut-off values.

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Accuracy of Ultrasound for Evaluation of Colorectal Segments in Patients With Inflammatory Bowel Diseases: A Systematic Review and Meta-analysis

Sagami

Kobayashi

Miyatani

et al. 2021

Clinical Gastroenterology and Hepatology

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P242 Accuracy of Doppler transabdominal ultrasound in assessing disease severity and extent in IBD

Cited by 4 publications

References 0 publications

Transperineal ultrasound predicts endoscopic and histological healing in ulcerative colitis

Transperineal ultrasound predicts endoscopic and histological healing in ulcerative colitis

Optimal use of serum leucine-rich alpha-2 glycoprotein as a biomarker for small bowel lesions of Crohn's disease

Accuracy of Ultrasound for Evaluation of Colorectal Segments in Patients With Inflammatory Bowel Diseases: A Systematic Review and Meta-analysis

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