Gastrointestinal ultrasound useful for assessing IBD

Last Updated: 2018-02-16

By Reuters Staff

NEW YORK (Reuters Health) - Gastrointestinal ultrasound (GIUS) accurately and noninvasively assesses disease activity in patients with inflammatory bowel disease (IBD), according to a review.

Mucosal healing is the current target of therapy in IBD, and endoscopy is typically used to evaluate this endpoint. CT and MRI are the most commonly employed alternatives.

Dr. Robert Venning Bryant from The Queen Elizabeth Hospital, Adelaide, South Australia, and colleagues provide evidence and guidelines for the use of GIUS in IBD patients in their February 3 online review in Gut.

Transabdominal GIUS can identify both luminal and extraintestinal pathology, and special techniques can be used to detect specific abnormalities: small intestine contrast ultrasound for detecting small-bowel Crohn's disease-related inflammation and stricturing; transperineal ultrasound for detecting perianal fistulas and abscesses; contrast-enhanced ultrasound for characterizing suspected abscesses; and elastography for distinguishing between inflammatory and fibrotic components of intestinal strictures.

The authors envision the use of GIUS by clinicians as an "extension of the examining hand," and they endorse GIUS performed within the radiology department as a means of increasing diagnostic accuracy in detecting pathology beyond the bowel.

GIUS can play important roles in diagnosing IBD, as well as in other goals such as assessing IBD disease activity, IBD complications, and response to IBD therapy, they note.

GIUS, however, is not recommended as a tool for surveillance in longstanding colitis, because there is no evidence that it is able to detect colitis-associated dysplasia.

"GIUS is a valuable non-invasive tool in the management of IBD that has the potential to shift clinical practice paradigms," the authors conclude. "Integrating a novel tool into established practice norms is challenging, and a coordinated approach at a national level is required, incorporating identifiable training and performance standards in GIUS, education and promotion of the role of GIUS in clinical practice and generation of local research evaluating the accuracy and utility of the technique to engender clinician confidence."

Dr. Bryant did not respond to a request for comment.

SOURCE: http://bit.ly/2nU7iby

Gut 2018.