Role of Noninvasive Imaging in the Diagnosis and Management of Patients With Suspected and Established Inflammatory Bowel Disease

Abstract

In a treat-to-target era, objective disease assessment in inflammatory bowel disease has become increasingly important. For many years, endoscopy has been generally accepted as the gold standard for evaluating the bowel mucosa, additionally facilitating biopsy. However, noninvasive disease assessment is now increasingly demanded, and cross-sectional imaging techniques, as well as video capsule endoscopy, have markedly improved. Emerging evidence demonstrates the added clinical value of transmural assessment both in Crohn's disease and ulcerative colitis, and cross-sectional imaging methods are increasingly used in phenotyping and monitoring patients with inflammatory bowel disease. In the current review, we propose potential algorithms to use noninvasive imaging in various clinical scenarios and for use in daily practice. The readers will come away with an understanding of what imaging they should consider for different clinical situations and the strengths and limitations of each method. Future developments of noninvasive diagnostic strategies and areas in need of further research are highlighted.

Keywords: Diagnostics; IBD; Intestinal Ultrasound; MRE; MRI; Video Capsule Endoscopy.