Role of intestinal ultrasound in ulcerative colitis: A systematic review

Table 13 Summary of studies evaluating role of point-of-care ultrasound in inflammatory bowel disease

Ref.	Study type	Comparator	Follow-up duration	Number of patients	Impact on management
Bots et al[60]	Retrospective	MRI, colonoscopy	MRE within 8 wk of IUS	345 (280 CD and 65 UC)	POCUS changed management in 60%; change in medications 48%; correlation with IUS 86.3%; correlation with MRI 80%; reduced use of MRI with increased adoption of IUS
Sathananthan et al[58]	Prospective	Ileocolonoscopy	POCUS & ileocolonocscopy within 30 d of one another	74 (CD 35; UC 39)	Correlation with same day colonoscopy (sensitivity 100%, specificity 100%, PPV 100%, NPV 100%, kappa 1); correlation with colonoscopy within 30 d (sensitivity 92%, specificity 86%, PPV 92%, NPV 86%, kappa 0.77 (MES ≥ 1); extent: Sensitivity 92%, specificity 80%, PPV 88%, NPV 86%, kappa 0.7
Carter et al[53]	Retrospective	MRE	Cross-sectional	11 UC (167 CD)	Sensitivity 90%; specificity: 23% as compared to colonoscopy/MRE (combined CD and UC); impact on management not evaluated
de Voogd et al[2]	Prospective, single centre cohort	Clinical activity and FCP	Prospective, single centre cohort study	16 UC, 22 CD	Impact on management (56.25%); treatment escalation: n = 6 (UC); continue same treatment: n = 3 (UC)
Saleh et al[89]	Retrospective	Clinical (UCAI ≤ 5 and partial Mayo ≤ 2) and biomarker remission (ESR ≤ 40 mm/h and CRP ≤ 10 mg/L and fecal calprotectin ≤ 50 µg/mg and fecal lactoferrin ≤ 30 µg/mL)	Mean time between follow-up IUS 203 d	39 UC, 108 CD	25 active UC on IUS; change in plan: 13; continue therapy: 11; deescalate therapy: 1; 14 inactive UC; 80.7% continued therapy (overall IBD); 5.2% deescalated therapy; 14% change in therapy Treatment change more in those with higher BWT (≥ 5 mm, < 5 mm-> 3 mm, ≤ 3 mm); Treatment change did not differ by CDS (Limberg’s score 0, 1, ≥ 2)
Lu et al[77]	Prospective, observational	Sigmoidoscopy, FCP, CTE/MRE	1 year	UC-16 (CD-46)	Change in management in 80% with IUS only (all IBD); Sigmoidoscopy + IUS 83% change in management

CD: Crohn’s disease; MRE: Magnetic resonance enterography; IUS: Intestinal ultrasound; UC: Ulcerative colitis; MRI: Magnetic resonance imaging; BWT: Bowel wall thickness; POCUS: Point-of-care intestinal ultrasound; HHIUS: Hand-held intestinal ultrasound.