Real-time intestinal ultrasound images promote shared understanding in IBD patients
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According to a presenter at the Crohn’s and Colitis Congress, point-of-care intestinal ultrasound in pediatric patients with inflammatory bowel disease eliminates intolerable preparation and promotes shared understanding.
“We need to reframe the way in which we're using imaging for monitoring and managing IBD patients,” Michael Dolinger, MD, MBA, advanced pediatric IBD fellow at the Icahn School of Medicine at Mount Sinai, said. “We can actually use imaging for tight control to show patient’s inflammation, improvement and lack thereof and adjust treatment therapies early to alter the natural history of IBD. The way we can do this is incorporating point-of-care intestinal ultrasound into a tight-control monitoring algorithm.”
Currently, the most common modalities for imaging in the U.S. are MRI and CT; however, among pediatric patients, these modalities come with intolerable contrast, sedation among younger children and radiation associated with CT. Further, results are not generated in real time and image review with the patient and their families rarely occurs.
Dolinger’s proposed algorithm involves use of ultrasound in tandem with MRI and colonoscopy at baseline, followed by use during the induction phase and throughout patient’s clinical visits. Rather than relying on outside-of-the-visit markers and slow results, this shows inflammation in real time and allows for timely adjustments in a patient’s IBD management course.
“It's real-time: the only test that we do in real time in IBD in which our patient sees what we're seeing together,” Dolinger said. “There's no preparation, there's no radiation and there's no contrast; we can do this as many times as we want.”
“It's accurate, it's reliable and, for me, the most important concept is we develop shared understanding with our patients. When this [inflammation and bowel wall abnormalities] is what they see, they understand why they're having symptoms or why they need treatment,” he added.
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Dolinger M. Presentation: State of the art imaging techniques for pediatric IBD. Presented at: Crohn’s and Colitis Congress; Jan. 20-22, 2022 (virtual meeting).
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