P1083Intestinal ultrasound is a cost-effective method of IBD assessment

Abstract Background Intestinal Ultrasound (IUS) is a non-invasive, point-of-care method of assessing inflammatory bowel disease (IBD). IUS is an established alternative to conventional modalities such as MRI1,2. This study aimed to assess the cost effectiveness of IUS compared with conventional methods of IBD assessment. Methods We used a costing model developed by Takeda Ireland, designed to compare costs of IUS and established assessment modalities. This model operates on the premise that IUS has similar sensitivity and specificity to magnetic resonance enterography (MRE) and endoscopy in appropriately selected patients. Separate pathways for IUS and MRE were mapped in the model and validated by two Irish gastroenterologists. We populated these pathways with relevant data from our centre to perform a cost comparison. Costs associated with IUS included operator costs, IUS machine purchase costs, and servicing/PACS costs. Costs associated with MRE included triage, scan costs and radiologist reporting cost. We included the costs of additional healthcare encounters in the MRE pathway, as median wait times for MRE were 188 days (IQR=156.5 days) versus 0 days for IUS (based on a recent audit from our centre using data from 2024/2025) - a prior Irish study had demonstrated that in a similar timeframe, 58.9% of patients required an outpatient appointment, 11% required an inpatient stay, 2.7% attended an emergency department, 9.6% needed alternative imaging such as CT, and only 17.8% did not require further services3. Results IUS costs €352.31 per patient, which compares favourably with MRE (€755.92) and colonoscopy (€1001) Figure 1. Prior local audit data highlighted 85% of patients referred for MRE are suitable for IUS, potentially saving €34307 per 100 patients. 65% of IBD endoscopy referrals could be assessed by IUS, saving €42164 per 100 patients. ∼400 IUS scans are performed annually in our centre, with potential savings of €137,000/annum (per operator). Conclusion IUS is a cost-effective and accurate modality. Investment in training and equipment to reach the full potential of IUS will improve patient access to rapid therapeutic decision-making and allow re-allocation of radiology and endoscopy resources. References: 1. Kucharzik T, Taylor S, Allocca M, et al, on behalf of the European Crohn’s and Colitis Organisation (ECCO), the European Society of Gastrointestinal and Abdominal Radiology (ESGAR), the European Society of Pathology (ESP), and the International Bowel Ultrasonography Group (IBUS), ECCO-ESGAR-ESP-IBUS Guideline on Diagnostics and Monitoring of Patients with Inflammatory Bowel Disease: Part 1: initial diagnosis, monitoring of known inflammatory bowel disease, detection of complications, Journal of Crohn’s and Colitis, Volume 19, Issue 7, July 2025, jjaf106, https://doi.org/10.1093/ecco-jcc/jjaf1062. 2. 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 Sep;22(9):1790-1795.e1. doi: 10.1016/j.cgh.2024.04.039. Epub 2024 Jul 10. PMID: 39001773. Available from: https://www.cghjournal.org/article/S1542-3565(24)00454-3/fulltext 3. Duignan J, Neary B, Moran C, Keegan D, Malone D, Doherty G. Clinical impact of prolonged wait times for MRE in patients with inflammatory bowel disease. Poster presented at: Irish Society of Gastroenterology Winter Meeting; 2015; Dublin, Ireland. ISGE. Available from: https://isge.ie/abstracts/clinical-impact-prolonged-wait-times-mre-patients-inflammatory-bowel-disease/ Conflict of interest: Dr. Mccrossan, Mark: No conflict of interest Allen, Kathryn: No conflict of interest McDonnell, Emma: No conflict of interest Mc Gettigan, Neasa: No conflict of interest Boland, Karen: No conflict of interest O’Toole, Aoibhlinn: No conflict of interest Rowan, Catherine: No conflict of interest