[en] BACKGROUND AND AIMS: Intestinal ultrasound (IUS) is increasingly used to monitor treatment efficacy in inflammatory bowel disease (IBD) trials. However, standardized definitions for response, remission, and optimal assessment timing remain undefined. An international expert consensus meeting was held to establish IUS endpoints for clinical trials. METHODS: A panel of 35 international gastroenterologists and radiologists participated in a modified Delphi process, reviewing the literature and developing consensus statements. Agreement was defined as at least 75% consensus. RESULTS: Consensus was reached on 150 statements across four domains: general IBD (30 statements), luminal Crohn's disease (CD) (43), perianal CD (51), and ulcerative colitis (UC) (26). For luminal CD and UC, ultrasound response was defined by: (1) a ≥25% reduction in bowel wall thickness (BWT) from baseline, or (2) multifactorial improvement, combining BWT reduction with ≥1 grade decrease in color Doppler signal (CDS) or another IUS parameter. Assessments were set at weeks 4-8 for the colon and week 12 for the terminal ileum. Ultrasound remission in luminal CD was defined as: (1) BWT normalization (≤3 mm) or (2) normalization of multiple parameters, including BWT, CDS, and all other IUS parameters. Similar remission criteria were proposed for UC, but the sigmoid BWT normal range (3-4 mm) remained uncertain. The bowel ultrasound score (BUSS) for CD and the Milan ultrasound criteria (MUC) for UC were supported as standardized scoring systems for trials. CONCLUSION: This consensus provides standardized IUS definitions to enhance consistency in IBD trials, supporting the integration of IUS in future research.
Disciplines :
Gastroenterology & hepatology
Author, co-author :
Allocca, Mariangela ; IRCCS Hospital San Raffaele and University Vita-Salute San Raffaele, Gastroenterology and Endoscopy, Milan, Italy.
Jairath, Vipul ; Division of Gastroenterology, Department of Medicine, Western University, London, ON, Canada.
Sands, Bruce E; Dr Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY, United States.
Rubin, David T; University of Chicago Medicine Inflammatory Bowel Disease Center, Chicago, IL, United States.
Caron, Bénédicte; University of Lorraine, Nancy University Hospital, Inserm, INFINY Institute, NGERE, Nancy, F-54000, France.
Laurent, Valérie; Department of Radiology, Nancy University Hospital, Université de Lorraine, Nancy, France.
Novak, Kerri ; Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
Panaccione, Remo ; Inflammatory Bowel Disease Unit, Division of Gastroenterology and Hepatology, University of Calgary, Calgary, Canada.
Bossuyt, Peter ; Imelda GI Clinical Research Center, Imelda General Hospital, Bonheiden, Belgium.
Bruining, David H; Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, United States.
Dignass, Axel; Department of Medicine I, Agaplesion Markus Hospital, Goethe-University, Frankfurt am Main, Germany.
Dotan, Iris; Division of Gastroenterology, Rabin Medical Center, Petah Tikva, Israel. ; Israel and the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Fletcher, Joel ; Department of Radiology, Mayo Clinic, Rochester, MN, United States.
Fumery, Mathurin ; Department of Gastroenterology, CHU Amiens and PériTox, UMR-I 01 INERIS, Picardie Jules Verne University, Amiens, France.
Furfaro, Federica; IRCCS Hospital San Raffaele and University Vita-Salute San Raffaele, Gastroenterology and Endoscopy, Milan, Italy.
Halfvarson, Jonas ; Department of Gastroenterology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
Hart, Ailsa; Inflammatory Bowel Diseases Unit, St Mark's Hospital, Harrow, United Kingdom.
Kobayashi, Taku ; Center for Advanced IBD Research and Treatment, Kitasato University Kitasato Institute Hospital, Tokyo, Japan.
Krugliak Cleveland, Noa; University of Chicago Medicine Inflammatory Bowel Disease Center, Chicago, IL, United States.
Kucharzik, Torsten; Department of Gastroenterology, Klinikum Lüneburg, Germany. ; Westfälische Wilhelms Universität Münster, Münster, Germany.
Laghi, Andrea; Department of Medical Surgical Sciences and Translational Medicine, Sapienza University of Rome, Rome, Italy.
Lakatos, Peter L ; Division of Gastroenterology and Hepatology, McGill University Health Center, Montreal, QC, Canada. ; Department of Oncology and Medicine, Semmelweis University, Budapest, Hungary.
Leong, Rupert W ; Department of Gastroenterology, Concord Repatriation General Hospital, Sydney, Australia.
Loftus, Edward V ; Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine and Science, Rochester, MN, United States.
Louis, Edouard ; Université de Liège - ULiège > Département des sciences cliniques > Hépato-gastroentérologie
Magro, Fernando; Unit of Pharmacology and Therapeutics, Department of Biomedicine, Faculty of Medicine, University of Porto, Porto, Portugal.
Olivera, Pablo A; Zane Cohen Centre for Digestive Diseases, Lunenfeld Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Ontario, Canada. ; Gastroenterology Section, Department of Internal Medicine, Centro de Educación Médica e Investigaciones Clínicas Norberto Quirno (CEMIC), Buenos Aires, Argentina.
Sebastian, Shaji ; Hull York Medical School, Hull University Teaching Hospitals, Hull, United Kingdom.
Siegmund, Britta ; Department of Gastroenterology, Infectiology and Rheumatology, Charité-Universitaetsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
Vavricka, Stephan R ; Department of Gastroenterology and Hepatology, University Hospital Zurich and University of Zurich, Zurich, Switzerland.
Wilson, Stephanie R; Department of Radiology, University of Calgary, Calgary, AB, Canada.
Stoker, Jaap ; Department of Radiology and Nuclear Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
Rimola, Jordi ; IBD unit, Department of Radiology, Hospital Clínic Barcelona, CIBER-EHD, IDIBAPS, Barcelona, Spain.
Peyrin-Biroulet, Laurent; University of Lorraine, Nancy University Hospital, Inserm, INFINY Institute, NGERE, Nancy, F-54000, France.
Danese, Silvio ; IRCCS Hospital San Raffaele and University Vita-Salute San Raffaele, Gastroenterology and Endoscopy, Milan, Italy.
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