Reliability of Intestinal Ultrasound for Evaluating Crohn's Disease Activity Using Point-of-care and Central Reading

Area of Science:

• Gastroenterology
• Medical Imaging
• Clinical Trials

Background:

• Intestinal ultrasound (IUS) is increasingly utilized for Crohn's disease (CD) activity assessment.
• Clinical trial application of IUS is hindered by inconsistent scoring and reliability concerns.

Purpose of the Study:

• To evaluate the inter- and intra-rater reliability of locally and centrally read IUS parameters for CD assessment.
• To prospectively analyze the reliability of specific IUS measurements in a workshop setting.

Main Methods:

• Twenty-four CD patients and six gastroenterologists participated in a 2-day workshop.
• Eight IUS parameters and overall sonographic activity were assessed by local and central readers.
• Reliability was quantified using intraclass correlation coefficients (ICCs).

Main Results:

• Five IUS parameters (BWT, CDS, i-fat, submucosal prominence, affected segment length) showed moderate inter- and intra-rater reliability.
• Centralized reading generally yielded higher reliability than local reading.
• Binary outcome assessment for BWS and i-fat, and focusing on the worst affected segment, enhanced reliability.

Conclusions:

• Local and central IUS reading demonstrated moderate reliability for several CD activity parameters.
• Findings support refining IUS activity indices and integrating central IUS reading into clinical trials.