Use of Cross-sectional Imaging for Tight Monitoring of Inflammatory Bowel Diseases

Mariangela Allocca, Silvio Danese, Valérie Laurent, Laurent Peyrin-Biroulet

Research output: Contribution to journalReview article

Abstract

A "treat-to-target" strategy with close monitoring of intestinal inflammation is recommended in inflammatory bowel disease (IBD). Ileocolonoscopy (CS) remains the gold-standard for assessing disease activity in IBD but is a relatively invasive procedure and is impossible to repeat in the context of tight monitoring strategies. In addition to biomarkers, cross-sectional imaging is increasingly used in these patients. Computed tomography is limited by the use of radiation, while the use of Magnetic Resonance Enterography (MRE) is limited by its cost and access. There is growing interest in bowel ultrasound (US) that represents a cost-effective, non-invasive and well-tolerated modality in clinical practice, but it is operator dependent. Compared to CS and MRE, bowel US has shown to have the same level of accuracy in assessing and monitoring disease activity for both CD and UC and can thus be considered as a point-of -care test. Diffusion-weighted imaging (DWI) is a MR imaging technique that is increasingly used in both IBD and non-IBD conditions and that has shown to be a valuable and accurate tool for assessing and monitoring IBD activity. Comparing to conventional MRE, DWI is quicker, less time-consuming, may not require intravenous contrast agent, fasting, bowel cleansing, oral or rectal preparation. The aim of this review is to discuss the role of these cross-sectional imaging techniques for the management of patients with IBD. In the near future, the value of DWI and US in assessing IBD will require further investigation in the era of transmural healing in CD and complete mucosal healing, including histologic remission, in UC.

Original languageEnglish
JournalClinical Gastroenterology and Hepatology
DOIs
Publication statusE-pub ahead of print - Dec 5 2019

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