Latest Intestinal Ultrasound Advancements In Inflammatory Bowel Disease
DOI:
https://doi.org/10.58931/cibdt.2024.2124Abstract
Inflammatory bowel disease (IBD) treatment has evolved from monitoring clinical symptoms to targeting objective measurements of mucosal healing with endoscopic and radiologic imaging. It is well known that clinical symptoms do not match disease severity. Frequent evaluation with radiologic imaging is now the standard of care. Although Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE-II) recommendations do not list radiographic targets as an endpoint due to the “limited ability of the currently available treatments to achieve transmural healing,” this will likely evolve over time particularly with the rapidly growing uptake of intestinal ultrasound (IUS) in clinical trials. For the time being, imaging is considered as an “adjuvant assessment rather than a formal treatment target.”
References
Turner D, Ricciuto A, Lewis A, D’Amico F, Dhaliwal J, Griffiths AM, et al. STRIDE-II: An Update on the Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE) Initiative of the International Organization for the Study of IBD (IOIBD): Determining Therapeutic Goals for Treat-to-Target strategies in IBD. Gastroenterology. 2021 Apr 1;160(5):1570–83. DOI: https://doi.org/10.1053/j.gastro.2020.12.031
Horsthuis K, Bipat S, Bennink RJ, Stoker J. Inflammatory bowel disease diagnosed with US, MR, scintigraphy, and CT: meta-analysis of prospective studies. Radiology. 2008 Apr;247(1):64–79. DOI: https://doi.org/10.1148/radiol.2471070611
Panés J, Bouzas R, Chaparro M, García-Sánchez V, Gisbert JP, Martínez de Guereñu B, et al. Systematic review: the use of ultrasonography, computed tomography and magnetic resonance imaging for the diagnosis, assessment of activity and abdominal complications of Crohn’s disease. Aliment Pharmacol Ther. 2011;34(2):125–45. DOI: https://doi.org/10.1111/j.1365-2036.2011.04710.x
Bots S, Nylund K, Löwenberg M, Gecse K, D’Haens G. Intestinal Ultrasound to Assess Disease Activity in Ulcerative Colitis: Development of a novel UCUltrasound Index. J Crohns Colitis. 2021 Jan 7;15(8):1264–71. DOI: https://doi.org/10.1093/ecco-jcc/jjab002
de Voogd F, van Wassenaer EA, Mookhoek A, Bots S, van Gennep S, Löwenberg M, et al. Intestinal Ultrasound Is Accurate to Determine Endoscopic Response and Remission in Patients With Moderate to Severe Ulcerative Colitis: A Longitudinal Prospective Cohort Study. Gastroenterology. 2022 Dec 1;163(6):1569–81. DOI: https://doi.org/10.1053/j.gastro.2022.08.038
Miles A, Bhatnagar G, Halligan S, Gupta A, Tolan D, Zealley I, et al. Magnetic resonance enterography, small bowel ultrasound and colonoscopy to diagnose and stage Crohn’s disease: patient acceptability and perceived burden. Eur Radiol. 2019 Mar;29(3):1083–93. DOI: https://doi.org/10.1007/s00330-018-5661-2
Rohatinsky N, Zelinsky S, Dolinger M, Christensen B, Wilkens R, Radford S, et al. Crohn’s Disease Patient Experiences and Preferences With Disease Monitoring: An International Qualitative Study. Crohns Colitis 360. 2023 Apr 1;5(2):otad012. DOI: https://doi.org/10.1093/crocol/otad012
St-Pierre J, Delisle M, Kheirkhahrahimabadi H, Goodsall TM, Bryant RV, Christensen B, et al. Bedside Intestinal Ultrasound Performed in an Inflammatory Bowel Disease Urgent Assessment Clinic Improves Clinical Decision-Making and Resource Utilization. Crohns Colitis 360. 2023 Oct 1;5(4):otad050. DOI: https://doi.org/10.1093/crocol/otad050
Bezzio C, Saibeni S, Vernero M, Furfaro F, Monteleone M, Ribaldone D, et al. The learning curve for using intestinal ultrasonography. Dig Liver Dis Off J Ital Soc Gastroenterol Ital Assoc Study Liver. 2024 Feb 5;S1590-8658(24)00222-6. DOI: https://doi.org/10.1016/j.dld.2024.01.192
Novak KL, Nylund K, Maaser C, Petersen F, Kucharzik T, Lu C, et al. Expert Consensus on Optimal Acquisition and Development of the International Bowel Ultrasound Segmental Activity Score [IBUS-SAS]: A Reliability and Inter-rater Variability Study on Intestinal Ultrasonography in Crohn’s Disease. J Crohns Colitis. 2021 Apr 6;15(4):609–16. DOI: https://doi.org/10.1093/ecco-jcc/jjaa216
Ripollés T, Poza J, Suarez Ferrer C, Martínez-Pérez MJ, Martín-Algíbez A, de Las Heras Paez B. Evaluation of Crohn’s Disease Activity: Development of an Ultrasound Score in a Multicenter Study. Inflamm Bowel Dis. 2021 Jan 1;27(1):145–54. DOI: https://doi.org/10.1093/ibd/izaa134
Allocca M, Fiorino G, Bonovas S, Furfaro F, Gilardi D, Argollo M, et al. Accuracy of Humanitas Ultrasound Criteria in Assessing Disease Activity and Severity in Ulcerative Colitis: A Prospective Study. J Crohns Colitis. 2018 Nov 28;12(12):1385–91. DOI: https://doi.org/10.1093/ecco-jcc/jjy107
Sævik F, Eriksen R, Eide GE, Gilja OH, Nylund K. Development and Validation of a Simple Ultrasound Activity Score for Crohn’s Disease. J Crohns Colitis. 2021 Jan 13;15(1):115–24. DOI: https://doi.org/10.1093/ecco-jcc/jjaa112
Dubé C, Rostom A. Acquiring and maintaining competency in gastrointestinal endoscopy. Best Pract Res Clin Gastroenterol. 2016 Jun;30(3):339–47. DOI: https://doi.org/10.1016/j.bpg.2016.05.004
Burwash IG, Basmadjian A, Bewick D, Choy JB, Cujec B, Jassal DS, et al. 2010 Canadian Cardiovascular Society/Canadian Society of Echocardiography Guidelines for Training and Maintenance of Competency in Adult Echocardiography. Can J Cardiol. 2011;27(6):862–4. DOI: https://doi.org/10.1016/j.cjca.2011.03.003
Novak KL, Wilson SR. Sonography for surveillance of patients with Crohn disease. J Ultrasound Med Off J Am Inst Ultrasound Med. 2012 Aug;31(8):1147–52. DOI: https://doi.org/10.7863/jum.2012.31.8.1147
Fraquelli M, Sarno A, Girelli C, Laudi C, Buscarini E, Villa C, et al. Reproducibility of bowel ultrasonography in the evaluation of Crohn’s disease. Dig Liver Dis. 2008 Nov;40(11):860–6. DOI: https://doi.org/10.1016/j.dld.2008.04.006
Calabrese E, Kucharzik T, Maaser C, Maconi G, Strobel D, Wilson SR, et al. Real-time Interobserver Agreement in Bowel Ultrasonography for Diagnostic Assessment in Patients With Crohn’s Disease: An International Multicenter Study. Inflamm Bowel Dis. 2018;24(9 PG-2001–2006):2001–6. DOI: https://doi.org/10.1093/ibd/izy091
Castiglione F, Mainenti PP, De Palma GD, Testa A, Bucci L, Pesce G, et al. Noninvasive diagnosis of small bowel Crohn’s disease: direct comparison of bowel sonography and magnetic resonance enterography. Inflamm Bowel Dis. 2013 Apr;19(5):991–8. DOI: https://doi.org/10.1097/MIB.0b013e3182802b87
Parente F, Greco S, Molteni M, Cucino C, Maconi G, Sampietro GM, et al. Role of early ultrasound in detecting inflammatory intestinal disorders and identifying their anatomical location within the bowel. Aliment Pharmacol Ther. 2003 Nov 15;18(10):1009–16. DOI: https://doi.org/10.1046/j.1365-2036.2003.01796.x
Taylor SA, Mallett S, Bhatnagar G, Baldwin-Cleland R, Bloom S, Gupta A, et al. Diagnostic accuracy of magnetic resonance enterography and small bowel ultrasound for the extent and activity of newly diagnosed and relapsed Crohn’s disease (METRIC): a multicentre trial. Lancet Gastroenterol Hepatol. 2018 Aug;3(8):548–58.
Furfaro F, D’Amico F, Zilli A, Craviotto V, Aratari A, Bezzio C, et al. Noninvasive Assessment of Postoperative Disease Recurrence in Crohn’s Disease: A Multicenter, Prospective Cohort Study on Behalf of the Italian Group for Inflammatory Bowel Disease. Clin Gastroenterol Hepatol Off Clin Pract J Am Gastroenterol Assoc. 2023 Nov;21(12):3143–51. DOI: https://doi.org/10.1016/j.cgh.2022.11.039
Yung DE, Har-Noy O, Tham YS, Ben-Horin S, Eliakim R, Koulaouzidis A, et al. Capsule Endoscopy, Magnetic Resonance Enterography, and Small Bowel Ultrasound for Evaluation of Postoperative Recurrence in Crohn’s Disease: Systematic Review and Meta-Analysis. Inflamm Bowel Dis. 2018 Jan 1;24(1):93–100. DOI: https://doi.org/10.1093/ibd/izx027
Andreoli A, Cerro P, Falasco G, Giglio LA, Prantera C. Role of ultrasonography in the diagnosis of postsurgical recurrence of Crohn’s disease. Am J Gastroenterol. 1998 Jul;93(7):1117–21. DOI: https://doi.org/10.1111/j.1572-0241.1998.00340.x
Rispo A, Bucci L, Pesce G, Sabbatini F, de Palma GD, Grassia R, et al. Bowel sonography for the diagnosis and grading of postsurgical recurrence of Crohn’s disease. Inflamm Bowel Dis. 2006 Jun 1;12(6):486–90. DOI: https://doi.org/10.1097/00054725-200606000-00007
Parente F, Sampietro GM, Molteni M, Greco S, Anderloni A, Sposito C, et al. Behaviour of the bowel wall during the first year after surgery is a strong predictor of symptomatic recurrence of Crohn’s disease: a prospective study. Aliment Pharmacol Ther. 2004 Nov 1;20(9):959–68. DOI: https://doi.org/10.1111/j.1365-2036.2004.02245.x
Maconi G, Sampietro GM, Cristaldi M, Danelli PG, Russo A, Bianchi Porro G, et al. Preoperative characteristics and postoperative behavior of bowel wall on risk of recurrence after conservative surgery in Crohn’s disease: a prospective study. Ann Surg. 2001 Mar;233(3):345–52. DOI: https://doi.org/10.1097/00000658-200103000-00007
Fernandes SR, Rodrigues RV, Bernardo S, Cortez-Pinto J, Rosa I, da Silva JP, et al. Transmural Healing Is Associated with Improved Long-term Outcomes of Patients with Crohn’s Disease. Inflamm Bowel Dis. 2017 Aug;23(8):1403–9. DOI: https://doi.org/10.1097/MIB.0000000000001143
Fernandes SR, Serrazina J, Botto IA, Leal T, Guimarães A, Garcia JL, et al. Transmural remission improves clinical outcomes up to 5 years in Crohn’s disease. United Eur Gastroenterol J. 2022 Dec 27;11(1):51–9. DOI: https://doi.org/10.1002/ueg2.12356
Geyl S, Guillo L, Laurent V, D’Amico F, Danese S, Peyrin-Biroulet L. Transmural healing as a therapeutic goal in Crohn’s disease: a systematic review. Lancet Gastroenterol Hepatol. 2021 Aug 1;6(8):659–67. DOI: https://doi.org/10.1016/S2468-1253(21)00096-0
Ilvemark JFKF, Hansen T, Goodsall TM, Seidelin JB, Al-Farhan H, Allocca M, et al. Defining Transabdominal Intestinal Ultrasound Treatment Response and Remission in Inflammatory Bowel Disease: Systematic Review and Expert Consensus Statement. J Crohns Colitis. 2022 May 10;16(4):554–80. DOI: https://doi.org/10.1093/ecco-jcc/jjab173
Kucharzik T, Wilkens R, D’Agostino MA, Maconi G, Le Bars M, Lahaye M, et al. Early Ultrasound Response and Progressive Transmural Remission After Treatment With Ustekinumab in Crohn’s Disease. Clin Gastroenterol Hepatol. 2023 Jan 1;21(1):153-163.e12.
Gordon IO, Agrawal N, Willis E, Goldblum JR, Lopez R, Allende D, et al. Fibrosis in Ulcerative Colitis is Directly Linked to Severity and Chronicity of Mucosal Inflammation. Aliment Pharmacol Ther. 2018 Apr;47(7):922–39. DOI: https://doi.org/10.1111/apt.14526
Ma L, Li W, Zhuang N, Yang H, Liu W, Zhou W, et al. Comparison of transmural healing and mucosal healing as predictors of positive long-term outcomes in Crohn’s disease. Ther Adv Gastroenterol. 2021;14:1–11. DOI: https://doi.org/10.1177/17562848211016259
Allocca M, Dell’Avalle C, Craviotto V, Furfaro F, Zilli A, D’Amico F, et al. Predictive value of Milan ultrasound criteria in ulcerative colitis: A prospective observational cohort study. United Eur Gastroenterol J. 2022 Mar;10(2):190–7. DOI: https://doi.org/10.1002/ueg2.12206
Carter D, Albshesh A, Shimon C, Segal B, Yershov A, Kopylov U, et al. Automatized Detection of Crohn’s Disease in Intestinal Ultrasound Using Convolutional Neural Network. Inflamm Bowel Dis. 2023 Dec 1;29(12):1901–6. DOI: https://doi.org/10.1093/ibd/izad014
Rieder F, Bettenworth D, Ma C, Parker CE, Williamson LA, Nelson SA, et al. An expert consensus to standardise definitions, diagnosis and treatment targets for anti-fibrotic stricture therapies in Crohn’s disease. Aliment Pharmacol Ther. 2018 Aug;48(3):347–57. DOI: https://doi.org/10.1111/apt.14853
Allocca M, Dal Buono A, D’Alessio S, Spaggiari P, Garlatti V, Spinelli A, et al. Relationships Between Intestinal Ultrasound Parameters and Histopathologic Findings in a Prospective Cohort of Patients With Crohn’s Disease Undergoing Surgery. J Ultrasound Med Off J Am Inst Ultrasound Med. 2023 Aug;42(8):1717–28. DOI: https://doi.org/10.1002/jum.16191
Bhatnagar G, Rodriguez-Justo M, Higginson A, Bassett P, Windsor A, Cohen R, et al. Inflammation and fibrosis in Crohn’s disease: location-matched histological correlation of small bowel ultrasound features. Abdom Radiol N Y. 2021 Jan;46(1):144–55. DOI: https://doi.org/10.1007/s00261-020-02603-6
Pruijt MJ, de Voogd FAE, Montazeri NSM, van Etten-Jamaludin FS, D’Haens GR, Gecse KB. Diagnostic Accuracy of Intestinal Ultrasound in the Detection of Intra-Abdominal Complications in Crohn’s Disease: A Systematic Review and Meta-Analysis. J Crohns Colitis. 2024 Jan 4;jjad215. DOI: https://doi.org/10.1093/ecco-jcc/jjad215
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