The role of intestinal ultrasound with colour Doppler in predicting the response to biologic therapy in inflammatory bowel disease patients

Introduction: Inflammatory bowel disease patients are exposed to frequent procedures and hospital admissions as well as recurrent need for radiological examinations with a high risk of exposure to radiation and contrast.

Aim: Our objective was to evaluate the role of a combination of both intestinal ultrasound (IUS) and colour Doppler with different parameters for monitoring changes in inflammation over time and to reveal their potential role in the assessment of response to biologic therapy in inflammatory bowel disease (IBD) patients.

Material and methods: Before the induction of biological therapy, IUS together with colour Doppler of the intestine was conducted. Response to therapy was defined following the international guidelines.

Results: A total of 45 patients with histopathological diagnosis of IBD were enrolled in the study. All patients received biological therapy and were assessed for response after 3 months. Out of those patients, 34 (75.6%) had good response while 11 (24.4%) failed to respond to the treatment. Our findings point to a strong association between bowel wall thickening (BWT) and serum albumin, erythrocyte sedimentation rate (ESR), and c-reactive protein (CRP). The overall sensitivity of IUS varied from 54 to 93% when evaluating bowel affection, with a specificity of 97-100%, in comparison to our results, which showed a sensitivity of 64-74% and specificity of 79-82%. Doppler parameters could predict the response to the biologic therapy in IBD patients.

Conclusions: Intestinal ultrasound and colour Doppler provide a safe, non-invasive way to monitor changes in inflammation and blood flow in the digestive tract.