Intestinal Ultrasound in Inflammatory Bowel Disease: From Point-of-Care Assessment to Standardized Treat-to-Target Monitoring
- 1Department of Gastroenterology, Colentina Clinical Hospital, Carol Davila University of Medicine, Bucharest, Romania
- 2Division of Gastroenterology and Gastrointestinal Endoscopy, IRCCS Ospedale San Raffaele and Vita-Salute San Raffaele University, Milan, Italy
Abstract
Intestinal ultrasound (IUS) is transitioning from a supplementary imaging technique to a reliable, point-of-care method for the objective monitoring of inflammatory bowel disease. Its clinical significance lies in its ability to directly assess bowel wall and extramural inflammation. It does not involve ionizing radiation, is well tolerated by patients, and can be used for disease reassessment during routine follow-up visits. The most reproducible markers of inflammatory activity are bowel wall thickness and color Doppler signal. Bowel wall stratification and the presence and extent of inflammatory mesenteric fat, strictures, and penetrating complications provide additional information on disease phenotype. Standardized instruments, including the International Bowel Ultrasound Segmental Activity Score for Crohn’s disease and the Milan Ultrasound Criteria for ulcerative colitis, improve comparability. Serial IUS examinations can assess treatment response within weeks and may identify residual or recurrent inflammation even when clinical improvement is attained. However, transmural healing remains an adjunctive target rather than an established treatment goal because clinical trials demonstrating that IUS-guided treatment escalation improves long-term outcomes are lacking. Broader implementation of IUS depends on standardized image acquisition and reporting, harmonized response definitions, competency-based training, and integration of IUS with symptoms, biomarkers, gastrointestinal endoscopy, and magnetic resonance enterography. Cite this article as: Rimbaș M, Furfaro F. Intestinal ultrasound in inflammatory bowel disease: From point-of-care assessment to standardized treat-to-target monitoring. Turk J Gastroenterol. Published online October 22, 2026. doi: 10.5152/tjg.2026.26656.
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BibTeX
@article{rimbaș2026intestinal,
title = {{Intestinal Ultrasound in Inflammatory Bowel Disease: From Point-of-Care Assessment to Standardized Treat-to-Target Monitoring}},
author = {Mihai Rimbaș and Federica Furfaro},
journal = {The Turkish Journal of Gastroenterology},
year = {2026},
month = oct,
doi = {10.5152/tjg.2026.26656},
url = {https://doi.org/10.5152/tjg.2026.26656},
note = {CC BY},
}
RIS
TY - JOUR
TI - Intestinal Ultrasound in Inflammatory Bowel Disease: From Point-of-Care Assessment to Standardized Treat-to-Target Monitoring
AU - Mihai Rimbaș
AU - Federica Furfaro
PY - 2026
DA - 2026/10/27
JO - The Turkish Journal of Gastroenterology
DO - 10.5152/tjg.2026.26656
UR - https://doi.org/10.5152/tjg.2026.26656
AB - Intestinal ultrasound (IUS) is transitioning from a supplementary imaging technique to a reliable, point-of-care method for the objective monitoring of inflammatory bowel disease. Its clinical significance lies in its ability to directly assess bowel wall and extramural inflammation. It does not involve ionizing radiation, is well tolerated by patients, and can be used for disease reassessment during routine follow-up visits. The most reproducible markers of inflammatory activity are bowel wall thickness and color Doppler signal. Bowel wall stratification and the presence and extent of inflammatory mesenteric fat, strictures, and penetrating complications provide additional information on disease phenotype. Standardized instruments, including the International Bowel Ultrasound Segmental Activity Score for Crohn’s disease and the Milan Ultrasound Criteria for ulcerative colitis, improve comparability. Serial IUS examinations can assess treatment response within weeks and may identify residual or recurrent inflammation even when clinical improvement is attained. However, transmural healing remains an adjunctive target rather than an established treatment goal because clinical trials demonstrating that IUS-guided treatment escalation improves long-term outcomes are lacking. Broader implementation of IUS depends on standardized image acquisition and reporting, harmonized response definitions, competency-based training, and integration of IUS with symptoms, biomarkers, gastrointestinal endoscopy, and magnetic resonance enterography. Cite this article as: Rimbaș M, Furfaro F. Intestinal ultrasound in inflammatory bowel disease: From point-of-care assessment to standardized treat-to-target monitoring. Turk J Gastroenterol. Published online October 22, 2026. doi: 10.5152/tjg.2026.26656.
SN - 2148-5607
ER -