Abstract Background Uptake of intestinal ultrasound (IUS) in the UK for the assessment of inflammatory bowel disease has been slow. We have set up an IUS service in radiology and aimed to review cost savings. Methods We performed a retrospective review and searched CRIS® for all patients with known or suspected IBD who had undergone an IUS. Our primary outcome was cost savings from avoidance of alternative tests for IBD assessment. Costs were extrapolated from the NHS National Tariff Workbook. Results From Aug 2024 to Oct 2025 we performed 107 IUS. We included 104/107 cases (3 performed for non-IBD indications). Median age was 41 (32-56) years. Patients had suspected IBD (3), Crohn’s disease (n = 91) L1 = 63, L2 = 5, L3 = 23; B1 = 31, B2 = 46, B3 = 14 or ulcerative colitis E1 = 1, E2 = 7, E3 = 2). Median body mass index (BMI) was 26 (23-31) kg/m2. 7 patients were pregnant (8-38/40 weeks). 76/104 patients were referred for symptomatic flare to assess disease activity. 28/104 were asymptomatic and were referred to monitor disease activity. 16 scans were suboptimal. Amongst these, clinical decision is pending in two patients and was based on clinical grounds (2), the initial calprotectin [fCal (4) or additional testing (Table 1). The median BMI in this cohort was 32 (27-34) kg/m2 and 3 patients were in their second or third trimester of pregnancy. 88/104 scans were considered adequate by the sonographer (Table 1). Amongst these, subsequent clinical decision making was made based on the IUS in 55/89 cases avoiding £13,000 worth of alternative investigations (IUS instead costing £2,451 in this group). 16/88 had IUS as a second test to assess if the disease was visible for follow up or tests were booked in tandem. Thus, both results were available at the point of clinical decision. Amongst these, results were concordant in 14/16 (1 false negative CT active IUS, 1 false negative IUS active MR). Additional tests were requested after IUS in 8/88 cases in patients who had discordant results/symptoms or disease phenotype/distribution that may be missed on IUS. 41% of additional tests were tandem tests with the cumulative savings from test avoidance greater than the cumulative cost of additional tests. Conclusion Integration of IUS into NHS services is likely to reduce expenditure. Costs above do not account for costs of MR reporting and the wider benefits of patient preference, access, the non-invasive nature of US and reduction in waiting lists (MR/endoscopy) when IUS is satisfactory. As seen in other units, 1 confidence in any new service increases over time and we expect tandem testing to reduce and referrals for IUS to increase respectively, further increasing the likely savings as the service develops. Reference: 1.Bots S, De Voogd F, De Jong M, et al. Point-of-care Intestinal Ultrasound in IBD Patients: Disease Management and Diagnostic Yield in a Real-world Cohort and Proposal of a Point-of-care Algorithm. J Crohns Colitis 2022;16(4):606-615. (In eng). DOI: 10.1093/ecco-jcc/jjab175. Conflict of interest: Ali, Noor: No conflict of interest Flower, Alice: No conflict of interest Dr. Meade, Susanna: Speaker Fees Falk pharma, Abbvie Conference fees/Ad board J and J
Ali et al. (Thu,) studied this question.