P0376 Advancing intestinal ultrasound for IBD in Turkey: results of a national survey
Authors: Bilican G , Karakan T , Eğritaş Gürkan Ö , Sabhan H , Hedin C , Forss A , Petrousis G , Cindoruk M , Can A , Haas S L 
Published: January 2025

Background

Intestinal ultrasound (IUS) is increasingly valued as a noninvasive tool for inflammatory bowel disease (IBD) management, enabling real-time, radiation-free assessment of bowel wall thickness, vascularity, and complications like abscesses.1 Studies show that IUS achieves accuracy levels comparable to traditional imaging methods.2,3 ECCO guidelines recommend the application of IUS for monitoring disease activity and assessing response to treatment.4 IUS is increasingly adopted in Europe and other regions. To date, there has been scarce data on the application of IUS in Turkey, a gap this study seeks to fill.

Methods

We conducted a nationwide, cross-sectional survey targeting both adult and pediatric gastroenterologists across Turkey. The survey was distributed to 817 adult and 150 pediatric gastroenterologists through the Turkish Society of Gastroenterology. The survey included 26 structured questions divided into sections on demographic data, familiarity with and usage of IUS, and perceived barriers to the implementation of IUS. Participants also provided information about their training in ultrasound and their institution type, experience level, and specialty focus.

Descriptive statistics were calculated to summarize the findings, and the Pearson Chi-square test was used to compare categorical data between groups.

Results

Of the 817 adult and 150 pediatric gastroenterologists contacted, a total of 191 responses were received, comprising 84 pediatric gastroenterologists (response rate: 56.0%) and 107 adult gastroenterologists (response rate: 13%). Regarding training in IUS, 73% (n=140) of respondents noted they had not received formal training.

Significant differences in IUS utilization were observed between pediatric and adult gastroenterologists (Figure 1). Adult gastroenterologists were more likely to perform IUS independently compared to pediatric gastroenterologists (29.0%, n=31 versus 2.4%, n=2; p&lt;0.001). Of note, 62.6% (n=67) of adult gastroenterologists and 46.4% (n=39) of pediatric gastroenterologists did not use IUS at all.

Altogether, 94% (n=179) of participants emphasized the necessity of expanding educational opportunities for gastroenterologists and expressed their willingness to attend a dedicated course (Figure 2). Additionally, 86.4% (n=165) favored the establishment of national guidelines to increase IUS adoption.

Conclusion

Our findings reveal a significant gap between the potential value of IUS in managing IBD and its current level of utilization in Turkey. Key barriers identified in our study include insufficient training opportunities, suggesting a clear need for structured educational programs and national IUS guidelines. Expanding IUS utilization has the potential to optimize IBD management in Turkey.

References

1.Chavannes M, Dolinger MT, Cohen-Mekelburg S, Abraham B. AGA Clinical Practice Update on the Role of Intestinal Ultrasound in Inflammatory Bowel Disease: Commentary. Clin Gastroenterol Hepatol. 2024;22(9):1790-1795.e1. doi:10.1016/j.cgh.2024.04.039.

2.Pruijt MJ, de Voogd FAE, Montazeri NSM, van Etten-Jamaludin FS, D’Haens GR, Gecse KB. Diagnostic accuracy of intestinal ultrasound in the detection of intra-abdominal complications in Crohn’s disease: A systematic review and meta-analysis. J Crohns Colitis. 2024;18(6):958-972. doi:10.1093/ecco-jcc/jjad215

3.Ivermark JFKF, Hansen T, Goodsall TM, Seidelin JB, Al-Farhan H, Allocca M, Begun J, Bryant RV, Carter D, Christensen B, Dubinsky MC, Gecse KB, Kucharzik T, Lu C, Maaser C, Maconi G, Nylund K, Palmela C, Wilson SR, Novak K, Wilkens R. Defining Transabdominal Intestinal Ultrasound Treatment Response and Remission in Inflammatory Bowel Disease: Systematic Review and Expert Consensus Statement. J Crohns Colitis. 2022;16(4):554-580. doi:10.1093/ecco-jcc/jjab173.

4.Verstockt B, Stoker J, et al. ECCO-ESGAR Guideline for Diagnostic Assessment in IBD Part 1: Initial diagnosis, monitoring of known IBD, detection of complications. J Crohns Colitis. 2019;13(2):144-164. doi:10.1093/ecco-jcc/jjy_154.