Arianna Dal Buono1, Francesco Faita2, Laurent Peyrin-Biroulet3, Silvio Danese4,5, Mariangela Allocca4,5. 1. IBD Center, Department of Gastroenterology, Humanitas Clinical and Research Center - IRCCS, Rozzano, Milan, Italy. 2. Italian National Research Council Institute of Clinical Physiology, Pisa, Italy. 3. Department of Gastroenterology and Inserm NGERE U1256, University Hospital of Nancy, University of Lorraine, Vandoeuvre-lès-Nancy, France. 4. Gastroenterology and Endoscopy, IRCCS Ospedale San Raffaele, Milan, Italy. 5. University Vita-Salute San Raffaele, Milan, Italy.
Abstract
BACKGROUND AND AIMS: Ultrasound elastography (USE) is an innovative, non-invasive, promptly available ancillary technique that has been proposed in the evaluation of intestinal fibrosis as a monitorable biomarker, in terms of stiffness. The non-invasive estimate of fibrosis by USE appears appealing for dedicated physicians, in order to optimize the treatments for inflammatory bowel disease (IBD) patients (surgical vs. non-surgical). We aimed to systematically review literature evidence on ultrasound elastography in IBD patients. METHODS: For this qualitative systematic review, we searched PubMed, EMBASE, and Scopus to identify all studies published until October 2021 investigating the application of USE in IBD patients compared to the histopathological assessment. RESULTS: Overall, 12 papers published between 2011 and 2019 were included. A total of 275 IBD patients were included: 272 CD (98,9%) and 3 UC (1,1%). Seven (58,3%) and four studies (41,6%) investigated strain elastography (SE) and shear wave elastography (SWE), respectively; in one study (0,1%) both techniques were addressed. The histological evaluation was largely conducted on surgical specimens, in two studies endoscopic biopsies were also included. The histologic assessment was semi-quantitative in all the included studies, except for two, where the fibrosis was evaluated only qualitatively. In 10/12 publications USE could accurately distinguish inflammation from fibrosis in the examined bowel tracts. CONCLUSIONS: From the preliminary available data, an overall moderate-to-good accuracy of USE in detecting histological fibrosis (10/12 studies) was found. Point-shear wave elastography has been shown to perform superiorly. Further studies are needed to confirm these evidences.
BACKGROUND AND AIMS: Ultrasound elastography (USE) is an innovative, non-invasive, promptly available ancillary technique that has been proposed in the evaluation of intestinal fibrosis as a monitorable biomarker, in terms of stiffness. The non-invasive estimate of fibrosis by USE appears appealing for dedicated physicians, in order to optimize the treatments for inflammatory bowel disease (IBD) patients (surgical vs. non-surgical). We aimed to systematically review literature evidence on ultrasound elastography in IBD patients. METHODS: For this qualitative systematic review, we searched PubMed, EMBASE, and Scopus to identify all studies published until October 2021 investigating the application of USE in IBD patients compared to the histopathological assessment. RESULTS: Overall, 12 papers published between 2011 and 2019 were included. A total of 275 IBD patients were included: 272 CD (98,9%) and 3 UC (1,1%). Seven (58,3%) and four studies (41,6%) investigated strain elastography (SE) and shear wave elastography (SWE), respectively; in one study (0,1%) both techniques were addressed. The histological evaluation was largely conducted on surgical specimens, in two studies endoscopic biopsies were also included. The histologic assessment was semi-quantitative in all the included studies, except for two, where the fibrosis was evaluated only qualitatively. In 10/12 publications USE could accurately distinguish inflammation from fibrosis in the examined bowel tracts. CONCLUSIONS: From the preliminary available data, an overall moderate-to-good accuracy of USE in detecting histological fibrosis (10/12 studies) was found. Point-shear wave elastography has been shown to perform superiorly. Further studies are needed to confirm these evidences.
Authors: Pierluigi Puca; Livio Enrico Del Vecchio; Maria Elena Ainora; Antonio Gasbarrini; Franco Scaldaferri; Maria Assunta Zocco Journal: Diagnostics (Basel) Date: 2022-08-17