ArticleIndian journal of gastroenterology : official journal of the Indian Society of Gastroenterology2026
Diagnostic accuracy of the international bowel ultrasound segmental activity score for assessing disease activity in Crohn's disease.
Article in Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundIntestinal ultrasound (IUS) has emerged as a promising bedside tool for evaluating disease activity in Crohn's disease (CD), but real-world data using standardized ultrasound activity scores remain limited.
methodsIn this cross-sectional observational study, patients with ileal, colonic or ileocolonic CD underwent IUS and ileocolonoscopy within a two-week interval. IUS findings were quantified using the International Bowel Ultrasound Segmental Activity Score (IBUS-SAS). Endoscopic activity was assessed using the Simple Endoscopic Score for Crohn's Disease (SES-CD). Diagnostic performance of IBUS-SAS for detecting endoscopic activity (SES-CD ≥ 3) was evaluated using receiver operating characteristic (ROC) analysis. Construct validity was assessed using Spearman correlation, discordance analyses and multi-variable logistic regression. Segment-level correlations and diagnostic accuracy were also examined.
resultsForty patients (median age 41 years; 18 [45%] female) with 160 bowel segments were analyzed. IBUS-SAS showed a moderate correlation with SES-CD (ρ = 0.45, p = 0.003) and FC (ρ = 0.35, p = 0.03. For detection of endoscopic activity, IBUS-SAS demonstrated an area under the ROC curve (AUC) of 0.75 (95% CI 0.52-0.97), numerically higher than FC, CRP and CDAI. At a cut-off of 24.0, IBUS-SAS achieved high sensitivity (96.7%) and negative predictive value (85.7%). Discordance analyses revealed progressively higher IBUS-SAS values with increasingly stringent composite definitions of disease activity. Segment-level analyses demonstrated stronger correlations and higher diagnostic accuracy in the transverse and left colon compared with the terminal ileum and ascending colon.
conclusionsThe IBUS-SAS correlates with disease activity in CD and shows potential utility as a non-invasive rule-out and monitoring tool.
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