Treat to transmural healing: how to incorporate intestinal ultrasound into the treatment of inflammatory bowel disease

Br J Radiol. 2022 Sep 1;95(1137):20211174. doi: 10.1259/bjr.20211174.Epub 2022 Jul 13.


Aysha H Al-Ani 1 2Rose Vaughan 1 2Britt Christensen 1 2Robert V Bryant 3 4Kerri L Novak 5


Author information

1Department of Medicine, University of Melbourne, Melbourne, Australia.

2Department of Gastroenterology, The Royal Melbourne Hospital, Melbourne, Australia.

3Department of Gastroenterology, The Queen Elizabeth Hospital, Woodville, Australia.

4School of Medicine, University of Adelaide, Adelaide, Australia.

5Department of Gastroenterology, The University of Calgary, Alberta, Australia.


Intestinal ultrasound (IUS) is emerging as a key tool to achieving the therapeutic target of transmural healing in inflammatory bowel disease (IBD). IUS is a non-invasive, radiation-free, imaging modality comparable to MRI, CT and ileocolonoscopy (IC). With the appropriate training and equipment, IUS can be an easily repeatable bedside test for IBD diagnosis and disease monitoring, including treatment response. Core to successful high quality IUS employment are appropriate training and expert techniques; however, the training pathway will not be explored in this review. Given the increasing shift towards objective assessment for tight disease control, gastroenterologist-led IUS should be incorporated into the armamentarium of imaging modalities alongside radiologists, to enhance our diagnostic and monitoring toolbox. This comprehensive review aims to outline the current literature around IUS and propose the placement of IUS in a treat-to-target algorithm in IBD. Ultimately, IUS facilitates timely management decisions to optimise patient care with potential to revolutionise patient outcomes, moving towards transmural healing as the holy grail of therapy in IBD.


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