Dr Dolinger discusses the use of advanced imaging such as intestinal ultrasound in managing inflammatory bowel disease among pediatric patients.

Michael Dolinger, MD, is an advanced pediatric inflammatory bowel disease fellow at the Icahn School of Medicine at Mt Sinai in New York, New York.

TRANSCRIPT:

Michael Dolinger, MD:  This is Michael Dolinger. I'm the advanced pediatric inflammatory bowel disease fellow at the Icahn School of Medicine at Mount Sinai. I just presented at the Crohn's and Colitis Congress on state-of-the-art imaging and pediatric inflammatory bowel disease.

The key takeaways from my presentation are that currently, we use imaging as a modality to assess disease extent, disease location, and complications. However, cross-sectional imaging can be used as a non-invasive biomarker for serial monitoring and tight control.

The most commonly used imaging modalities in IBD centers across the country right now are MRI and CT. These are not ideal modalities for tight control, because they're expensive, in children, they may require sedation or radiation, and they have difficult-to-tolerate contrast.

However, point-of-care intestinal ultrasound is an ideal tool to use for this serial monitoring that we can see very similar findings if not higher resolution than MRI and CT. And we can track overtime at every visit while the patient is in the room to get results to make treatment decisions and use this cross-sectional imaging tool as a way to affect the natural history and change the course of pediatric inflammatory bowel disease.

In addition, we should be defining disease severity based on the amount of fibrosis and active inflammation. Currently, our tools are inadequate to do this. However, shear wave elastography and ultrasound may be a new way in which we can do this at baseline for our patients to better stratify them, and risk-predict for the future.