S1618 Early Results of a New Intestinal Ultrasound Program as a Real-Time Disease Monitoring Tool in Patients With Crohn’s Disease: A Retrospective Case Series

Introduction: Intestinal ultrasound (IUS) is a non-invasive and inexpensive point-of-care disease monitoring tool that has been slowly getting incorporated into clinical practice in the US. The aim of our retrospective case series was to assess the accuracy of IUS in the management of Crohn’s disease (CD) patients within our institution’s new IUS program. Methods: Adult patients ≥18 years old with CD who underwent IUS between July and November 2024 at Scripps Clinic were included. Indications for IUS were to assess disease activity or response to therapy. Data on clinical disease activity scores, recent endoscopic/radiographic findings, and fecal calprotectin (FC) were collected. The primary endpoint of the study was to assess the correlation between IUS findings and clinical, biochemical, endoscopic, and radiographic (CT or MR enterography) disease state within 6 months of IUS. Results: A total of 69 adult patients (mean age = 50.7 years, male gender = 30) with CD (ileal = 26, ileocolonic = 33, colonic = 10) underwent IUS over the designated study period. Of those, 21 (30.4%) had prior abdominal surgeries (small bowel resection = 4, ileocecectomy = 12, right hemicolectomy = 4, colectomy = 1). Thirty-five percent (24/69) of patients failed at least one prior biologic therapy. Forty-seven patients (68%) were on biologic therapy when IUS was performed. IUS was not completed in 2 patients due to limited views and patient discomfort. Forty-three percent (29/67) of patients had IUS findings consistent with radiographic remission. IUS findings were concordant with clinical symptoms in 91% (61/67) of patients. IUS findings were also concordant with luminal disease extent/severity, radiographic findings, and FC in 96.8% (30/31), 93.1% (27/29), and 88.5% (46/52) of cases, respectively. The use of IUS helped guide escalating and de-escalating therapy in 28 (41%) and 5 (7%) patients, respectively. Three patients (4%) were referred to surgery when IUS findings were taken along with clinical context. In the remaining 52% of patients, IUS was helpful to confirm radiographic remission and response, which led to the continuation of the same therapy. Conclusion: Our retrospective study demonstrates that IUS is a promising disease monitoring tool in CD patients as findings accurately correlate with clinical symptoms as well as biochemical, endoscopic, and radiographic disease state. It helped provide valuable real-time data, which led to therapy modification in almost 50% of included patients.