Abstract Background Intestinal ultrasound (IUS) is a reliable and non-invasive tool for assessing and monitoring patients affected by inflammatory bowel disease (IBD), supporting clinicians in day-to-day decision-making.¹ IUS allow to measure bowel wall thickness (BWT) as well as to evaluate wall stratification, hypervascularization, and the presence of stenosis or dilatation, lymphadenopathy, mesenteric activation, and free fluid.² Among these, BWT is the only quantitative measure, while the other parameters are qualitative or semi-quantitative.³ Consequently, IUS is prone to considerable inter-and intra-observer variability in the perception and interpretation of results. Similarly to endoscopy, recent years have seen a surge in interest in the development of standardized IUS scoring systems. These scores aim to objectify the technique, enabling longitudinal comparisons, especially after biologic therapy induction. Currently available scores comprise IBUS-SAS, BUSS, SUS-CD, and Simple-US for Crohn’s disease (CD), and the MUC score for ulcerative colitis (UC).4,5 Our aim was to develop a mobile app that rapidly calculates the main IUS scores, supporting clinicians in everyday IBD practice and clinical research. Methods We developed a cross-platform mobile app (iOS and Android) featuring a simple, user-friendly interface. Notably, the application was entirely developed by a physician with limited coding experience, thanks to the guidance from ChatGPT-3-o-Mini. The app was built on the open-source Flutter framework using Xcode and Android Studio. A beta version was tested with selected users, and then released and freely available for download on the App Store and Google Play Store. Results The app “IUS-IBD Scores Calculator”, allows to calculates five IUS scores (IBUS-SAS, BUSS, SUS-CD, Simple-US, MUC). Users can select the desired score, enter the required parameters, and instantly receive the result. Each score is implemented according to its validated algorithm and includes thresholds that define disease activity and remission, based on the latest scientific literature. When available, diagnostic accuracy metrics (sensitivity and specificity) are also provided to support clinical interpretation. By facilitating standardized assessments of disease activity, the tool may enhance clinical decision-making and reduce variability in IUS interpretation. Conclusion This app represents the first practical, evidence-based tool, to enhance IUS Scores in daily IBD management. By enabling rapid and standardized scoring, it may facilitate the integration of IUS more effectively into routine care and research. Moreover, this experience highlights the potential of AI systems to support skill-acquisition and foster creativity. References: 1. Maaser, C. et al. ECCO-ESGAR Guideline for Diagnostic Assessment in IBD Part 1: Initial diagnosis, monitoring of known IBD, detection of complications. J Crohns Colitis 144–164 (2019) doi:10.1093/ecco-jcc/jjy113. 2. Atkinson, N. S. S et al. How to perform gastrointestinal ultrasound: Anatomy and normal findings. World Journal of Gastroenterology vol. 23 6931–6941 Preprint at https://doi.org/10.3748/wjg.v23.i38.6931 3. Goertz, R. S., Hensel, S., Wildner, D., Neurath, M. F. & Strobel, D. Bowel wall thickening and hyperemia assessed by high-frequency ultrasound indicate histological inflammation in Crohn’s ileitis. Abdominal Radiology 46, 1855–1863 (2021). 4. Dragoni, G. et al. Correlation of Ultrasound Scores with Endoscopic Activity in Crohn’s Disease: A Prospective Exploratory Study. J Crohns Colitis 17, 1387–1394 (2023). 5. Allocca, M. et al. Predictive value of Milan ultrasound criteria in ulcerative colitis: A prospective observational cohort study. United European Gastroenterol J 10, 190–197 (2022). Conflict of interest: Dr. Stalla, Francesco Maria: No conflict of interest Pessarelli, Tommaso: No conflict of interest Mendolaro, Marco: No conflict of interest Pecorella, Giulia: No conflict of interest Carboni, Edoardo: No conflict of interest Stradella, Davide: No conflict of interest Rocca, Rodolfo: No conflict of interest Daperno, Marco: Personal Fees: Takeda, Johnson & Johnson, GILEAD, Roche, Pfizer, Abbvie, Ferring, Chiesi, Alfasigma, Celltrion, Sanofi Other: Clinical trials: Takeda, Janssen, Roche
Stalla et al. (Thu,) studied this question.