IBUS-SAS Is a Highly Accurate Intestinal Ultrasound Score for Predicting Endoscopic Disease Activity in Ulcerative Colitis

Fischer S, Fischmann D, Wilde J, Vetter M, Wolf L, Geppert CI, Atreya R, Waldner M, Strobel D, Neurath M, Haberkamp S, Zundler S (2025)

Publication Language: English

Publication Type: Journal article

Publication year: 2025

Journal

United European Gastroenterology Journal SAGE Publications

DOI: 10.1002/ueg2.70053

Abstract

Background: The international bowel ultrasound group-segmental activity score (IBUS-SAS) is a validated tool with high interobserver agreement for accurately detecting disease activity in Crohn's disease (CD). Here, we addressed whether the IBUS-SAS is also suitable to assess disease activity in ulcerative colitis (UC). Methods: The IBUS-SAS and Limberg scores were determined in the sigmoid colon of patients with UC. The results were correlated to established scores of clinical, endoscopic and histologic disease activity (partial [pMS] and endoscopic [eMS] Mayo-Score, ulcerative colitis endoscopic index of severity [UCEIS], histologic Nancy index) and/or biomarkers of inflammation (C-reactive protein [CRP], fecal calprotectin). Sensitivity, specificity, positive (PPV) and negative predictive values (NPV) for IBUS-SAS and the Limberg score to predict endoscopic and histologic disease activity were computed by receiver operating characteristics (ROC)-analysis. Results: Fifty-eight patients with UC were enrolled. The median IBUS-SAS was 34.8. It was significantly correlated with pMS, eMS, UCEIS, Nancy index, CRP and fecal calprotectin. On ROC-analysis, a cut-off of 15.9 was reached with 100% sensitivity and 80.0% specificity for the prediction of endoscopic activity, resulting in a PPV of 94.7% and an NPV of 100%. The Limberg score performed only slightly worse (100.0%, 60.0%, 89.9%, 100%, respectively). Comparable results were found regarding the Nancy index for sensitivity (93.9% vs. 93.9%), specificity (57.1% vs. 42.9%), PPV (91.4% vs. 88.9%) and NPV (65.7% vs. 59.0%). Conclusions: This study highlights the potential of IUS for the non-invasive quantification of disease activity in UC and suggests that the IBUS-SAS should be considered as a diagnostic tool in trials and real-world management of UC.

Authors with CRIS profile

Sarah Fischer Department of Medicine 1 – Gastroenterology, Pneumology and Endocrinology Marcel Vetter Department of Medicine 1 – Gastroenterology, Pneumology and Endocrinology Laurin Wolf Department of Medicine 1 – Gastroenterology, Pneumology and Endocrinology Carol-Immanuel Geppert Institute of Pathology Raja Atreya Professur für Translationale Immunforschung bei chronisch entzündlichen Darmerkrankungen Maximilian Waldner Professur für Funktionelle Bildgebung in der Medizin Deike Strobel Medizinische Fakultät Markus Neurath Lehrstuhl für Innere Medizin I (Medizin 1) Sophie Haberkamp Department of Medicine 1 – Gastroenterology, Pneumology and Endocrinology Sebastian Zundler Department of Medicine 1 – Gastroenterology, Pneumology and Endocrinology

How to cite

APA:

Fischer, S., Fischmann, D., Wilde, J., Vetter, M., Wolf, L., Geppert, C.-I.,... Zundler, S. (2025). IBUS-SAS Is a Highly Accurate Intestinal Ultrasound Score for Predicting Endoscopic Disease Activity in Ulcerative Colitis. United European Gastroenterology Journal. https://doi.org/10.1002/ueg2.70053

MLA:

Fischer, Sarah, et al. "IBUS-SAS Is a Highly Accurate Intestinal Ultrasound Score for Predicting Endoscopic Disease Activity in Ulcerative Colitis." United European Gastroenterology Journal (2025).

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