EFSUMB Recommendations and Clinical Guidelines for Intestinal Ultrasound (GIUS) in Inflammatory Bowel Diseases

Abstract

The accuracy and usefulness of gastrointestinal ultrasound (GIUS) for detecting activity and complications of inflammatory bowel diseases (IBD), has been reported in studies, promoting this technique as an important tool for the management of IBD patients. Whilst well recognised by international guidelines, standardization and general agreement in the definition of the luminal and extra-intestinal features, still need to be well defined.A task force group of 17 experts in GIUS faced this issue, by developing recommendations and clinical guidelines for the use of GIUS in IBD, under the auspices of EFSUMB. This article presents the consensus on the current data on sonographic features of IBD and summarises the accuracy of different sonographic modalities for the management of IBD patients.

Gastrointestinal Ultrasound Can Predict Endoscopic Activity in Crohn’s Disease

“…Remission was defined as a BWT < 3 mm in both the colon and terminal ileum (▶ Fig. 1) [12], while a cut-off of < 4 mm was used in the rectum.…”

“…As numerous follow-up examinations for monitoring disease status are needed, gastrointestinal ultrasound (GIUS) might be an attractive modality. GIUS has high diagnostic accuracy for detecting CD [11], where increased bowel wall thickness (BWT) is the most important and common ultrasonographic parameter [12]. Previous studies showed that ultrasonographic changes during medical treatment correlate with endoscopic response and may provide measurements of MH [13][14][15].…”

State of the art in the teaching of digestive ultrasound

“…To overcome this important limitation, an international team of experts in GIUS, with the endorsement of the European Federation of the Societies of Ultrasound in Medicine and Biology (EFSUMB), was created in 2016, with the aim to standardize definitions in IBD and other gastrointestinal diseases and to promote its use in a clinical setting [7]. The implementation of these universally applicable standardized measurements will provide a basis for measuring, evaluating and improving performance and quality of care in GIUS [10].…”

“…Since then, technological US advancements and increased skills of sonographers, most of them gastroenterologists, broadened its use to diagnosis and monitoring several intestinal diseases, in particular inflammatory bowel disease (IBD). Systematic reviews and meta-analyses have shown that GIUS, Computed Tomography scan (CT) and Magnetic Resonance Imaging (MRI) have similar accuracy for the evaluation of IBD [2][3][4][5], and currently GIUS is recommended by several international guidelines as the first examination in patients with abdominal complaints to detect appendicitis, diverticulitis, bowel occlusion and inflammatory bowel diseases [6][7][8][9]. The advantages of GIUS over other imaging techniques are its relatively low cost, the widely available equipment and potential prompt use and the lack of contraindications or harmful conditions such as ionizing radiation or claustrophobia [10].…”

Editorial on the Current Role of Ultrasound

“…US can be applied in a traditional fashion, for examination of the abdomen by gastroenterologists and surgeons [10][11][12][13][14], the pelvis by gynaecologists [15,16], the heart by cardiologists [17], the mediastinum and lung by pneumologists, and other anatomical regions examined by their respective specialists. The role of radiology depends on historical issues and traditions [18][19][20][21].…”