Systematic Reviews
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Meta-Anal. Sep 18, 2024; 12(3): 97210
Published online Sep 18, 2024. doi: 10.13105/wjma.v12.i3.97210
Role of intestinal ultrasound in ulcerative colitis: A systematic review
Partha Pal, Mohammad Abdul Mateen, Kanapuram Pooja, Nandhakumar Rajadurai, Rajesh Gupta, Manu Tandan, Nageshwar Reddy Duvvuru
Partha Pal, Kanapuram Pooja, Nandhakumar Rajadurai, Rajesh Gupta, Manu Tandan, Nageshwar Reddy Duvvuru, Department of Medical Gastroenterology, Asian Institute of Gastroenterology, Hyderabad 500082, India
Mohammad Abdul Mateen, Department of Diagnostic Radiology and Imaging, Asian Institute of Gastroenterology, Hyderabad 500082, India
Author contributions: Pal P conceptualized the work, performed the literature search, wrote the first draft, and provided intellectual input; Mateen MA conceptualized the work, supervised the writing, and critically revised the manuscript; Pooja K performed the literature search, wrote the first draft, and revised the manuscript; Rajadurai N performed the literature search and helped in writing the first draft; Gupta R, Tandan M, and Reddy DN supervised the literature search and the writing, provided intellectual input, and critically revised the manuscript.
Conflict-of-interest statement: All authors have no conflicts of interest to disclose.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Partha Pal, DNB, FASGE, MD, MRCP, Attending Doctor, Department of Medical Gastroenterology, Asian Institute of Gastroenterology, 6-3-661 Red Rose Cafe Lane, Sangeet Nagar, Somajiguda, Hyderabad 500082, India. partha0123456789@gmail.com
Received: May 25, 2024
Revised: August 7, 2024
Accepted: August 14, 2024
Published online: September 18, 2024
Processing time: 110 Days and 19.2 Hours
Abstract
BACKGROUND

Intestinal ultrasound (IUS) is an emerging, non-invasive, and highly sensitive diagnostic tool in inflammatory bowel disease (IBD), including ulcerative colitis (UC). Despite its potential, its adoption in clinical practice is limited due to a lack of standardization and awareness.

AIM

To perform a comprehensive scoping review based on a systematic literature review on IUS in UC to inform current practice.

METHODS

Ninety-nine original articles about ultrasonography in UC were identified among 7608 citations searching PubMed and EMBASE databases for systematic review.

RESULTS

IUS can be useful as an initial diagnostic strategy in patients with suspected IBD/UC. In UC, IUS can predict endoscopic response, histologic healing, and steroid responsiveness in acute severe cases. IUS can predict response to biologics/small molecules (as early as 2 wk). IUS correlates well with ileo-colonoscopy, but IUS could miss rectal, jejunal, and upper GI lesions in suspected IBD and colon polyps or extra-intestinal manifestations in known IBD. IUS is useful in special situations (children, pregnancy, and postoperative Crohn's disease). Inter-observer agreement is acceptable and trained physicians have comparable diagnostic accuracy. Point-of-care ultrasound impacted management in 40%-60% of cases. Hand-held IUS has excellent agreement with conventional IUS.

CONCLUSION

IUS is a non-invasive, highly sensitive tool in the diagnosis and monitoring of UC, offering excellent patient satisfaction. Point-of-care ultrasound by IBD physicians can significantly impact clinical decision-making.

Keywords: Ulcerative colitis; Intestinal ultrasound; Inflammatory bowel disease; Diagnosis; Monitoring

Core Tip: Intestinal ultrasound (IUS) is an emerging non-invasive diagnostic tool for ulcerative colitis (UC) with high sensitivity. This scoping review demonstrates IUS's effectiveness in predicting endoscopic response, histologic healing, and steroid responsiveness in UC, as well as its role in early prediction of biologic response. While IUS may not detect all lesions, it shows excellent agreement with ileo-colonoscopy and is valuable in special situations like pregnancy and pediatric cases. Hand-held IUS matches conventional IUS in accuracy. Point-of-care IUS by inflammatory bowel disease physicians can significantly influence clinical decisions, underscoring its potential for broader clinical adoption.