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. 2025 Jun 16.
doi: 10.1007/s10396-025-01554-z. Online ahead of print.

Changes in proximal colon on intestinal ultrasound indicate the efficacy of induction therapy for active ulcerative colitis

Koichi Izumikawa  1 , Tomoki Inaba  2 , Eriko Yasutomi  2 , Sakuma Takahashi  2 , Hugh Shunsuke Colvin  2 , Ichiro Sakakihara  2 , Kumiko Yamamoto  2 , Shigetomi Tanaka  2 , Shigenao Ishikawa  2 , Masaki Wato  2
Affiliations

Changes in proximal colon on intestinal ultrasound indicate the efficacy of induction therapy for active ulcerative colitis

Koichi Izumikawa et al. J Med Ultrason (2001). .

Abstract

Purpose: This study aimed to elucidate the effectiveness of intestinal ultrasound (IUS) in assessing induction therapy for active ulcerative colitis (UC).

Methods: Thirty-two patients (12 with severe colitis and 20 with moderate colitis) were analyzed. Disease activity was assessed using the Mayo endoscopic score (MES) obtained via colonoscopy. Ultrasound (US) grade and bowel wall thickness (BWT) before induction therapy were compared in terms of MES. Changes in US grade and BWT from pre-treatment to clinical improvement were analyzed at the most inflamed segments, oral side, and anal side.

Results: A correlation coefficient of 0.58 (p < 0.01) indicated a strong correlation between US grade and MES. US grade and BWT decreased at the most inflamed segments, oral side, and anal side for clinical improvement in all cases (p < 0.01, p < 0.01, respectively). However, changes in US grade were significantly greater on the oral side than the most inflamed segments or the anal side (p = 0.008 and p = 0.039, respectively).

Conclusion: IUS is an effective method for assessing the efficacy of induction therapy for active UC. The assessment should be performed at the proximal part of the colon, rather than solely at the site of the most pronounced inflammation.

Keywords: Colitis; Colonoscopy; Induction therapy; Ulcerative; Ultrasonography.

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Conflict of interest statement

Declarations. Conflict of interest: Koichi Izumikawa, Tomoki Inaba, Eriko Yasutomi, Sakuma Takahashi, Colvin Hugh Shunsuke, Ichiro Sakakihara, Kumiko Yamamoto, Shigetomi Tanaka, Shigenao Ishikawa, and Masaki Wato declare no conflicts of interest. Ethical statements: All patients provided written informed consent before commencement of the study. This single-center study was conducted in accordance with the guidelines of the Declaration of Helsinki, approved by our institutional review board (Registry No. 1173), and pre-registered at the University Hospital Medical Information Network Center (UMIN Clinical Trials Registry, number R000061633). Regarding the presentation and publication of research, informed consent is given prior to the start of testing, and this information is also made known on the Kagawa Prefectural Central Hospital website. The patient could withdraw consent from the study at any time.

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