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Volume 16
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Review

Intestinal Ultrasound-Guided Precision Medicine in Inflammatory Bowel Diseases: A Narrative Review

by
Cicerone Clelia
1,
Fabrizio Fanizzi
1,2,
Arianna Dal Buono
3,4,
Ilaria Faggiani
1,2,
Ferdinando D’Amico
1,
Alessandra Zilli
1,
Tommaso Lorenzo Parigi
1,2,
Virginia Solitano
1,2,
Federica Furfaro
2,3,
Sara Massironi
2,5,
Alessandro Armuzzi
3,4,
Silvio Danese
1,2 and
Mariangela Allocca
1,*
1
Department of Gastroenterology and Endoscopy, IRCCS Hospital San Raffaele, 20132 Milan, Italy
2
Faculty of Medicine and Surgery, Vita e Salute San Raffaele University, 20132 Milan, Italy
3
IBD Center, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Italy
4
Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20072 Milan, Italy
5
Gastroenterology Unit, Istituti Ospedalieri Bergamaschi, Zingonia, 24046 Bergamo, Italy
*
Author to whom correspondence should be addressed.
J. Pers. Med. 2026, 16(7), 339; https://doi.org/10.3390/jpm16070339 (registering DOI)
Submission received: 10 April 2026 / Revised: 8 June 2026 / Accepted: 18 June 2026 / Published: 23 June 2026
(This article belongs to the Special Issue Personalized Management of Inflammatory Bowel Diseases)
Versions Notes

Abstract

Inflammatory bowel diseases (IBD), including Crohn’s disease and ulcerative colitis, are characterized by marked heterogeneity, challenging disease monitoring and individualized treatment. Despite advances in treat-to-target strategies, unmet needs persist, particularly in assessing transmural healing and optimizing therapeutic decisions. This narrative review evaluates the role of intestinal ultrasound (IUS) as a key tool for precision medicine in IBD. IUS is a non-invasive, repeatable, and cost-effective imaging modality with diagnostic accuracy comparable to endoscopy and magnetic resonance enterography, with reported sensitivities and specificities frequently exceeding 80–90% for detecting active disease. It enables real-time assessment of transmural inflammation and complications, while parameters such as bowel wall thickness and Doppler vascularity support prognostic stratification. Early reductions in bowel wall thickness (≥25–30%) have been associated with improved treatment response, allowing identification of responders within weeks of therapy initiation. IUS informs therapeutic decision-making, including initiation, optimization, and de-escalation of advanced therapies, and may reduce reliance on invasive procedures. Integration into routine care has been associated with improved disease control and cost-effectiveness. Standardization of protocols, operator training, and prospective validation are required to establish IUS as a cornerstone of precision medicine in IBD.
Keywords: IBD; Inflammatory Bowel Disease; IUS; Intestinal Ultrasound; precision medicine; personalized medicine IBD; Inflammatory Bowel Disease; IUS; Intestinal Ultrasound; precision medicine; personalized medicine

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MDPI and ACS Style

Clelia, C.; Fanizzi, F.; Dal Buono, A.; Faggiani, I.; D’Amico, F.; Zilli, A.; Parigi, T.L.; Solitano, V.; Furfaro, F.; Massironi, S.; et al. Intestinal Ultrasound-Guided Precision Medicine in Inflammatory Bowel Diseases: A Narrative Review. J. Pers. Med. 2026, 16, 339. https://doi.org/10.3390/jpm16070339

AMA Style

Clelia C, Fanizzi F, Dal Buono A, Faggiani I, D’Amico F, Zilli A, Parigi TL, Solitano V, Furfaro F, Massironi S, et al. Intestinal Ultrasound-Guided Precision Medicine in Inflammatory Bowel Diseases: A Narrative Review. Journal of Personalized Medicine. 2026; 16(7):339. https://doi.org/10.3390/jpm16070339

Chicago/Turabian Style

Clelia, Cicerone, Fabrizio Fanizzi, Arianna Dal Buono, Ilaria Faggiani, Ferdinando D’Amico, Alessandra Zilli, Tommaso Lorenzo Parigi, Virginia Solitano, Federica Furfaro, Sara Massironi, and et al. 2026. "Intestinal Ultrasound-Guided Precision Medicine in Inflammatory Bowel Diseases: A Narrative Review" Journal of Personalized Medicine 16, no. 7: 339. https://doi.org/10.3390/jpm16070339

APA Style

Clelia, C., Fanizzi, F., Dal Buono, A., Faggiani, I., D’Amico, F., Zilli, A., Parigi, T. L., Solitano, V., Furfaro, F., Massironi, S., Armuzzi, A., Danese, S., & Allocca, M. (2026). Intestinal Ultrasound-Guided Precision Medicine in Inflammatory Bowel Diseases: A Narrative Review. Journal of Personalized Medicine, 16(7), 339. https://doi.org/10.3390/jpm16070339

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