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Life
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Imaging in Inflammatory Bowel Disease
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Imaging in Inflammatory Bowel Disease

A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Radiobiology and Nuclear Medicine".

Deadline for manuscript submissions: closed (31 May 2021) | Viewed by 19193

Special Issue Editors

Prof. Dr. Sandro Ardizzone

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Guest Editor
Gastrointestinal Unit, ASST Fatebenefratelli Sacco—Department of Biochemical and Clinical Sciences "L. Sacco", University of Milan, 20157 Milan, Italy
Interests: inflammatory bowel disease; digestive endoscopy; Immunomediate; inflammatory disease
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Giovanni Maconi

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Guest Editor
Gastrointestinal Unit, ASST Fatebenefratelli Sacco—Department of Biochemical and Clinical Sciences "L. Sacco", University of Milan, 20157 Milano, Italy
Assoc. Prof. Marietta Iacucci

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Guest Editor
NIHR Biomedical Research Centre, Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham B15 2TT, UK
Interests: inflammatory bowel disease; advanced endoscopy; artificial intelligence

Special Issue Information

Dear Colleagues,

Inflammatory bowel diseases (IBD) are chronic-relapsing inflammatory conditions involving different areas of the gastrointestinal tract, and require lifelong management.

Ulcerative colitis (UC) is mainly a continuous mucosal disease of the colon starting at the rectum, whilst Crohn’s disease (CD) is a transmural inflammation and may affect any section of the gastrointestinal tract, most commonly the ileocolonic region. The involvement in CD can be patchy with skip lesions.

During the last few decades, different imaging approaches have been developed for the evaluation of IBD. In UC, the gold standard for the diagnosis, assessment, and surveillance remains ileocolonoscopy with biopsies, by using high-definition (HD) instruments in particular. However, new techniques, such as dye and virtual chromoendoscopy, confocal laser endomicroscopy (CLE), endocytoscopy and trans-abdominal ultrasonography (US) are emerging as valid diagnostic and monitoring tools in the assessment of UC or detection of dysplastic lesions at surveillance. Similar approaches could be used in colonic or ileo-colonic CD patients.

The small bowel assessment in CD includes mucosal evaluation using video capsule endoscopy and device-assisted enteroscopy, alongside cross-sectional imaging, such as intestinal US, abdominal computed tomography (CT) enterography and magnetic resonance imaging (MRI) enterography. Moreover, upper gastrointestinal CD requires gastroscopy with biopsies, whilst the gold standard for the assessment of perianal CD is MRI of the pelvis. Trans-perineal and transrectal US, in absence of anal stenosis, are emerging imaging techniques in the evaluation of perianal CD.

Prof. Dr. Sandro Ardizzone
Prof. Dr. Giovanni Maconi
Assoc. Prof. Marietta Iacucci
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Life is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • inflammatory bowel disease
  • advanced endoscopy
  • bowel ultrasound
  • small bowel capsule endoscopy
  • magnetic resonance enterography
  • artificial intelligence

Published Papers (4 papers)

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Research

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10 pages, 877 KiB  
Article
Ultrasound-Verified Peripheral Arthritis in Patients with HLA-B*35 Positive Spondyloarthritis
by Daniela Šošo, Jure Aljinović, Sanja Lovrić Kojundžić, Ivanka Marinović, Esma Čečuk Jeličić and Daniela Marasović Krstulović
Life 2021, 11(6), 524; https://doi.org/10.3390/life11060524 - 4 Jun 2021
Cited by 2 | Viewed by 2301
Abstract
Background: We aimed to investigate possible association between the HLA-B*35 allele and peripheral arthritis, tenosynovitis and enthesitis. Methods: Ultrasound of peripheral joints and tendons was performed in 72 HLA-B*35 positive patients with preliminary diagnosis of undifferentiated axial form of spondyloarthitis and joint and [...] Read more.
Background: We aimed to investigate possible association between the HLA-B*35 allele and peripheral arthritis, tenosynovitis and enthesitis. Methods: Ultrasound of peripheral joints and tendons was performed in 72 HLA-B*35 positive patients with preliminary diagnosis of undifferentiated axial form of spondyloarthitis and joint and tendon pain. Patients with other known types of axial and peripheral spondyloarthritis were excluded as well as patients with other known types of arthritis. Results: Pathological changes were found in the joints of 33 (46%) patients and on the tendons in 13 (18%) patients. The most common ultrasound findings were joint effusion and synovial proliferation with positive power Doppler signal grade 1. The most common ultrasound finding in patients with painful tendons was tenosynovitis. A higher disease activity and an increased incidence of elevated CRP (≥5 mg/L) were more often observed in the group with positive ultrasound findings. Conclusion: In this study, we showed that the HLA-B*35 allele could be a potential risk factor for developing peripheral arthritis, but not for tenosynovits and enthesitis in patients with the undifferentiated axial form of spondyloarthritis. This result may influence the follow up of these patients, especially since it gives us an opportunity to consider the use of different types of DMARDs in the treatment of these patients. Full article
(This article belongs to the Special Issue Imaging in Inflammatory Bowel Disease)
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Review

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12 pages, 2616 KiB  
Review
Bowel Ultrasound in Inflammatory Bowel Disease: How Far in the Grayscale?
by Federica Furfaro, Arianna Dal Buono, Mariangela Allocca, Ferdinando D'Amico, Alessandra Zilli, Roberto Gabbiadini and Silvio Danese
Life 2021, 11(7), 649; https://doi.org/10.3390/life11070649 - 4 Jul 2021
Cited by 7 | Viewed by 5804
Abstract
Bowel ultrasound (BUS) is a non-invasive and accurate technique for assessing activity, extension of disease, and complications in inflammatory bowel diseases. The main advantages of BUS are its safety, reproducibility, and low costs. Ancillary technologies of BUS (i.e., color Doppler and wave elastography) [...] Read more.
Bowel ultrasound (BUS) is a non-invasive and accurate technique for assessing activity, extension of disease, and complications in inflammatory bowel diseases. The main advantages of BUS are its safety, reproducibility, and low costs. Ancillary technologies of BUS (i.e., color Doppler and wave elastography) could broaden the diagnostic power of BUS, allowing one to distinguish between inflammation and fibrosis. Considering the costs and invasiveness of colonoscopy and magnetic resonance, BUS appears as a fast, safe, and accurate technique. The objective measures of disease allow one to make clinical decisions, such as optimization, switch, or swap of therapy. Previous studies reported a sensitivity and a specificity of more than 90% compared to endoscopy and magnetic resonance. Lastly, transperineal ultrasound (TPUS) is a promising approach for the evaluation of perianal disease in Crohn’s disease (CD) and disease activity in patients with ulcerative proctitis or pouchitis. Bowel ultrasound is being incorporated in the algorithm of managing inflammatory bowel diseases. Transmural healing evaluated through ultrasonography is emerging as a complementary target for disease treatment. In this review, we aimed to summarize and discuss the current evidence on BUS in the management of inflammatory bowel diseases and to address the challenges of a full validation of this technique. Full article
(This article belongs to the Special Issue Imaging in Inflammatory Bowel Disease)
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14 pages, 13340 KiB  
Review
Role of Intestinal Ultrasound in the Management of Patients with Inflammatory Bowel Disease
by Aranzazu Jauregui-Amezaga and Jordi Rimola
Life 2021, 11(7), 603; https://doi.org/10.3390/life11070603 - 23 Jun 2021
Cited by 5 | Viewed by 5890
Abstract
Intestinal ultrasound (IUS) has gained popularity as a first line technique for the diagnosis and monitoring of patients with inflammatory bowel diseases (IBD) due to its many advantages. It is a non-invasive imaging technique with non-ionizing radiation exposure. It can be easily performed [...] Read more.
Intestinal ultrasound (IUS) has gained popularity as a first line technique for the diagnosis and monitoring of patients with inflammatory bowel diseases (IBD) due to its many advantages. It is a non-invasive imaging technique with non-ionizing radiation exposure. It can be easily performed not only by radiologists but also by trained gastroenterologists at outpatient clinics. In addition, the cost of IUS equipment is low when compared with other imaging techniques. IUS is an accurate technique to detect inflammatory lesions and complications in the bowel in patients with suspected or already known Crohn’s disease (CD). Recent evidence indicates that IUS is a convenient and accurate technique to assess extension and activity in the colon in patients with ulcerative colitis (UC), and can be a non-invasive alternative to endoscopy. In patients with IBD, several non-specific pathological ultrasonographic signs can be identified: bowel wall thickening, alteration of the bowel wall echo-pattern, loss of bowel stratification, increased vascularization, decreased bowel peristalsis, fibro-fatty proliferation, enlarged lymph nodes, and/or abdominal free fluid. Considering the transmural CD inflammation, CD complications such as presence of strictures, fistulae, or abscesses can be detected. In patients with UC, where inflammation is limited to mucosa, luminal inflammatory ultrasonographic changes are similar to those of CD. As the technique is related to the operator’s experience, adequate IUS training, performance in daily practice, and a generalized use of standardized parameters will help to increase its reproducibility. Full article
(This article belongs to the Special Issue Imaging in Inflammatory Bowel Disease)
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9 pages, 617 KiB  
Review
Wireless Capsule Endoscopy for Diagnosis and Management of Post-Operative Recurrence of Crohn’s Disease
by Adil Mir, Vu Q. Nguyen, Youssef Soliman and Dario Sorrentino
Life 2021, 11(7), 602; https://doi.org/10.3390/life11070602 - 23 Jun 2021
Cited by 7 | Viewed by 3880
Abstract
Despite aggressive medical therapy, many patients with Crohn’s disease require surgical intervention over time. After surgical resection, disease recurrence is common. Ileo-colonoscopy and the Rutgeerts score are commonly used for diagnosis and monitoring of post-operative endoscopic recurrence. The latter is the precursor of [...] Read more.
Despite aggressive medical therapy, many patients with Crohn’s disease require surgical intervention over time. After surgical resection, disease recurrence is common. Ileo-colonoscopy and the Rutgeerts score are commonly used for diagnosis and monitoring of post-operative endoscopic recurrence. The latter is the precursor of clinical recurrence and therefore it impacts prognosis and patient management. However, due to the limited length of bowel assessed by ileo-colonoscopy, this procedure can miss out-of-reach, more proximal lesions in the small bowel. This limitation introduces an important uncertainty when evaluating post-operative relapse by ileo-colonoscopy. In addition, the Rutgeerts score ‘per se’ bears a number of ambiguities. Here we will discuss the pros and cons of ileo-colonoscopy and other imaging studies including wireless capsule endoscopy to diagnose and manage post-operative recurrence of Crohn’s disease. A number of studies provide evidence that wireless capsule endoscopy is a potentially more accurate as well as less invasive and less costly alternative to conventional techniques including ileo-colonoscopy. Full article
(This article belongs to the Special Issue Imaging in Inflammatory Bowel Disease)
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