Can Intestinal Ultrasound Accurately Gauge UC Treatment Response?

Intestinal ultrasound demonstrated high accuracy in determining treatment response in patients with moderate to severe ulcerative colitis, according to study findings published online in Gastroenterology.

“Intestinal ultrasound is noninvasive, cost-effective, and accurate to determine disease activity in ulcerative colitis,” wrote corresponding author Krisztina Gecse, MD, PhD, of Amsterdam University Medical Centers in The Netherlands, and coauthors. “In this study, we prospectively evaluated intestinal ultrasound for treatment response in a longitudinal cohort by using endoscopy and histology as gold standards.”

The study included 30 consecutive patients with an endoscopic Mayo score of 2 or higher who were starting tofacitinib. Patients underwent clinical, biochemical, endoscopic, histologic, and intestinal ultrasound assessments at baseline and 8 weeks after starting tofacitinib. A total of 27 patients completed follow-up.

At both baseline and 8 weeks, bowel wall thickness correlated with endoscopic Mayo score, ulcerative colitis endoscopic index for severity, and Robarts Histopathologic Index, the study showed.

“Bowel wall thickness in the sigmoid was lower in patients with endoscopic remission (1.4 mm vs 4.0 mm, P = .016), endoscopic improvement (1.8 mm vs 4.5 mm, P < .0001) and decrease in bowel wall thickness was more pronounced in patients with endoscopic response (-58.1% vs -13.4%, P = .018),” researchers wrote.

For the study, endoscopic Mayo scores of 0 were used to indicate endoscopic remission, 1 or less to indicate endoscopic improvement, and a decrease of 1 or more to signal endoscopic response.

The most accurate cutoff values for bowel wall thickness were 2.8 mm for endoscopic remission, 3.9 mm for improvement, and decrease of 32% for response, researchers reported. The most responsive wall layer was the submucosa.

“Intestinal ultrasound, importantly bowel wall thickness as the single most important parameter, is highly accurate to detect treatment response when evaluated against endoscopic outcomes,” the authors concluded.

—Jolynn Tumolo

Reference
de Voogd F, van Wassenaer EA, Mookhoek A, et al. Intestinal ultrasound is accurate to determine endoscopic response and remission in patients with moderate to severe ulcerative colitis: a longitudinal prospective cohort study. Gastroenterology. Published online August 24, 2022. doi:10.1053/j.gastro.2022.08.038