Contrast-Enhanced Endoscopic Ultrasound Detects Early Therapy Response Following Anti-TNF Therapy in Patients with...

Area of Science:

• Gastroenterology
• Medical Imaging
• Inflammatory Bowel Disease

Background:

• Colonoscopy is limited to mucosal assessment in active ulcerative colitis (aUC).
• Endoscopic ultrasound with contrast-enhancement (dCEUS) quantifies bowel wall thickness and microvascularity.
• dCEUS offers potential for quantitative inflammation evaluation in aUC.

Purpose of the Study:

• To prospectively assess therapy response using dCEUS in aUC patients treated with adalimumab (ADA) or infliximab (IFX).
• To evaluate dCEUS as an early predictive marker for treatment success in aUC.

Main Methods:

• Thirty ADA- and 15 IFX-treated aUC patients underwent dCEUS at baseline and weeks 2, 6, 14, and 48.
• Bowel wall thickness (BWT) and vascularity (rise time, time to peak) were measured by dCEUS.
• Therapy response was defined by Mayo Score at 14 weeks.

Main Results:

• Responders showed significant reduction in BWT by week 2 (p=0.04) and normalized time to peak (p=0.001).
• Non-responders exhibited no significant changes in BWT or time to peak.
• Mayo Score at week 2 did not predict treatment response.

Conclusions:

• dCEUS enables early detection of therapy response in aUC patients.
• dCEUS serves as a predictive marker for long-term clinical success.
• dCEUS is a valuable diagnostic tool for assessing future therapy success probability in aUC.