Abstract Background Magnetic resonance enterography (MRE) and colonoscopy (CS) are used to monitor disease activity in patients with inflammatory bowel disease (IBD). Intestinal ultrasound (IUS) has emerged as a non-invasive point of care tool for evaluation of disease activity in IBD. Several studies demonstrate that IUS has comparable accuracy to MRE and CS. 1, 2 We aimed to evaluate the utility of IUS in influencing management change in IBD and the cost-effectiveness of a newly established intestinal ultrasound service in a tertiary IBD unit. Methods A retrospective single-centre review was performed of all IUS examinations conducted for IBD disease activity assessment at a tertiary centre between January 2024 to October 2025. Data collected included patient demographics, diagnosis, prior surgery, impact of IUS on management, and avoidance of additional imaging or colonoscopy. The estimated cost in Australian dollars (AUD) of MRE (560), CS (2000) and IUS (212) were derived from published Australian data to calculate system-wide cost savings. Results A total of 438 IUS examinations were analysed. Of these, 234 (53. 4%) were in female patients, with a median age 44 years (IQR: 30-57), 371 (85%) with Crohn’s disease, 57 (13%) with ulcerative colitis and 10 (2%) with pouch-disorders. 191 (43. 6%) of patients had undergone a prior intestinal surgery. Two-hundred and twenty-five (51. 4%) IUS examinations demonstrated active disease. Clinicians altered clinical management based on 175 out of 438 IUS examinations (39. 9%). IUS based management avoided 199 MREs and 139 colonoscopies. The total savings from MRE avoided was 111, 440, and total savings from CS avoided was 278, 000. The total expenditure on IUS was 92, 856. The net total cost savings amounted to 296, 584. Conclusion IUS is a valuable and cost-effective investigation offering rapid, non-invasive and patient-centred assessment of IBD disease activity. Integration of IUS into routine clinical pathways substantially reduces downstream healthcare utilization by limiting unnecessary invasive and high-cost investigations, improving workflow efficiency and optimizing resource allocation. References: 1. Allocca M, Fiorino G, Bonifacio C, et al. Comparative accuracy of bowel ultrasound versus magnetic resonance enterography in combination with colonoscopy in assessing Crohn’s disease and guiding clinical decision-making. J Crohns Colitis. 2018;12 (11): 1280-1287. doi: 10. 1093/ecco-jcc/jjy093. 2. Shivaji UN, Segal JP, Plumb AA, Quraishi MN, Ghosh S, Iacucci M. Intestinal ultrasonography: a useful skill for efficient, non-invasive monitoring of patients with IBD using a clinic-based point-of-care approach. Frontline Gastroenterol. 2021;13 (5): 447-451. doi: 10. 1136/flgastro-2021-101852. Conflict of interest: Dr. Mian, Ibrahim: No conflict of interest Ford, Timothy: No conflict of interest Haig, Adam: No conflict of interest Subhaharan, Deloshaan: No conflict of interest Mohsen, Waled: No conflict of interest Kakkadasam Ramaswamy, Pradeep: No conflict of interest
Mian et al. (Thu,) studied this question.