Intestinal ultrasound in Crohn’s disease: A systematic review of its role in diagnosis, monitoring, and treatment response

Table 15 Summary of studies evaluating role of point of care ultrasound in inflammatory bowel disease

Ref.	Study type	Comparator	Follow up	Number of patients	Impact on management
Novak et al[18], 2015	Prospective	CRP, Harvey Bradshaw Index	2 years	49 CD	POCUS changed management (escalation, de-escalation, surgery referral) in nearly 60% of cases. Half of the patients with clinically inactive disease had IUS activity
Wright et al[186], 2020	Prospective cross-sectional	MRE and ileo-colonoscopy	POCUS done within 3 months of MRE	42 CD	Compared to MRE, POCUS was accurate in assessing disease activity, extent, and complications. POCUS had moderate agreement with MRE (κ = 0.50) and ileo-colonoscopy (κ = 0.55)
Gonen et al[193], 2021	Prospective	Colonoscopy	3 months	117 CD	POCUS changed management in 40% of cases. Accuracy of decision improved from 63% to 90%. Surgical decisions were taken in 11% of cases. Colonoscopy and POCUS assessments were comparable
Bots et al[20], 2022	Retrospective	MRI, Colonoscopy	MRE within 8 weeks of IUS	345 (280 CD and 65 UC)	POCUS changed management in 60% of cases, leading to a 48% change in medications. Correlation with IUS was 86.3%, and correlation with MRI was 80%. Adoption of IUS reduced the reliance on MRI
Rispo et al[173], 2023	Prospective	Ileo-colonoscopy, IUS	Cross-sectional	86 UC	Hand-held IUS and standard IUS were comparable in terms of BWT and BWS Excellent agreement between HHIUS and IUS (κ= 0.86)
St-Pierre et al[196], 2023	Multicenter observational	N/A	Cross-sectional	158 IBD	POCUS detected active inflammation in 65% of cases, leading to changes in IBD-specific medications in 57%. Avoided or delayed urgent endoscopy in 85%, significantly improving resource utilization and reducing procedural burden

CD: Crohn’s disease; MRE: Magnetic resonance enterography; IUS-Intestinal ultrasound; UC: Ulcerative colitis; MRI: Imagnetic resonance imaging; BWT: Bowel wall thickness; POCUS: Point of care intestinal ultrasound; IBD: Inflammatory bowel diseases; CRP: C-reactive protein; BWS: Bowel wall stratification.