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Searches followed Cochrane and PRISMA guidance, and selected prospective studies were evaluated with QUADAS-2 by two independent reviewers. Results identify bowel wall thickness (BWT) and dynamic BWT change as the most consistent predictors, with selected cut-offs and vascularity-based criteria improving discrimination.",{"@graph":14,"@context":73},[15,34,56],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/research-report/","Research & 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Colitis—A Systematic Review  \nSabrina Josefsen 1, Tobias Reinhold Larsen 1,2, Rune Wilkens 2,3, Jakob Benedict Seidelin 1,3, Johan Burisch 3,4,5, Mohamed Attauabi 1,4, * and Jacob Tveiten Bjerrum 1,3  \nAcademic Editor: Akira Horiuchi  \nReceived: 1 December 2025  \nRevised: 15 December 2025  \nAccepted: 17 December 2025  \nPublished: 20 December 2025  \nCopyright: © 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license.  \n1 Department of Gastroenterology, Copenhagen University Hospital—Herlev Hospital, 2730 Herlev, Denmark  \n2 Digestive Disease Center, Copenhagen University Hospital—Bispebjerg Hospital, 2400 Copenhagen, Denmark  \n3 Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, 2100 Copenhagen, Denmark  \n4 Copenhagen Center for Inflammatory Bowel Disease in Children, Adolescents, and Adults, Hvidovre Hospital, 2650 Hvidovre, Denmark  \n5 Gastrounit, Medical Section, Copenhagen University Hospital—Hvidovre Hospital, 2650 Hvidovre, Denmark  \n* [Correspondence: mohamed.attauabi.01@regionh.dk](Correspondence: mohamed.attauabi.01@regionh.dk)  \nAbstract  \nBackground/Objectives: Intestinal ultrasound (IUS) is increasingly used to monitor ulcerative colitis (UC), but its predictive value remains unclear. This systematic review evaluated the ability of IUS parameters and scores to predict short-and long-term treatment response, remission, and adverse outcomes in hospitalized and outpatient UC populations. Methods: A systematic review was conducted according to Cochrane and PRISMA guidelines. MEDLINE and Embase were searched for prospective studies assessing IUS as a predictor of clinical or endoscopic response, remission, relapse, or adverse outcomes in adult UC. Two reviewers independently performed screening, data extraction, and QUADAS-2 assessment. Results: Eighteen prospective studies were included: eleven outpatient studies and seven involving hospitalized patients treated with intravenous corticosteroids (IVCS) . In hospitalized patients, bowel wall thickness (BWT) was the most consistent predictor of treatment failure, rescue therapy, colectomy, and clinical response. Baseline BWT showed variable performance, but once IVCS was initiated, early BWT change within 48–72 h was the strongest marker of disease trajectory. Non-responders had higher BWT and smaller reductions. A BWT ≥ 4 mm, absolute reduction ≤ 1 mm, or relative reduction ≤ 20% at 48 h reliably identified patients needing rescue therapy (area under the curve (AUC) values of 0.77 (95% confidence interval (CI) 0.71–0.74), 0.71 (95% CI 0.56–0.86), and 0.74 (95% CI 0.60–0.88)) . Colectomy risk was similarly predicted: BWT \u003C 3 mm at 48 h was associated with no colectomies, whereas BWT ≥ 4 mm or persistently elevated BWT at day 6 markedly increased risk (Odds ratio (OR) 9.5-fold (95% CI 1.4–64.0) and OR 8.3 (95% CI 1.7–40.0), respectively) . Other sonographic features (loss of haustration, increased vascularity) added supplementary but less consistent value. In outpatients, BWT also demonstrated the strongest predictive accuracy. BWT ≤ 3.6 mm at 2 weeks and \u003C3.0 mm at 6 weeks were associated with early endoscopic remission (area under the receiver operating characteristic (AUROC) of 0.87 (95% CI 0.71–1.00) and 0.82 (95% CI 0.63–1.00), respectively) . Dynamic changes with ≥23–25% relative reduction predicted clinical or endoscopic response (AUROC of 0.81 (95% CI 0.61–1.00) and OR of 13.9 (95% CI 1.13–1986.85), respectively) . Persistent BWT > 3.5 mm or minimal reduction (\u003C20% or \u003C1 mm) indicated a low likelihood of long-term remission. Composite vascularity-based indices, particularly the Milan Ultrasound Criteria (MUC), strengthened prediction: MUC ≤ 4.3 or ≥2-point reduction at 12 we","cbCaitRoRnlYJKYs","https://ap.wps.com/l/cbCaitRoRnlYJKYs","pdf",913107,17,"English","# Abstract\n## Background/Objectives\n## Methods\n## Results\n## Conclusions\n# Introduction\n## Disease features and burden\n## Rationale for monitoring and early prediction","[{\"question\":\"What was the main purpose of the systematic review?\",\"answer\":\"To evaluate whether intestinal ultrasound (IUS) parameters and scores can predict short- and long-term treatment response, remission, relapse, and adverse outcomes in adult ulcerative colitis populations.\"},{\"question\":\"Which IUS parameter showed the strongest predictive value?\",\"answer\":\"Bowel wall thickness (BWT) was consistently the strongest predictor of outcomes such as treatment failure, rescue therapy, colectomy, and clinical response, especially after initiation of intravenous corticosteroids.\"},{\"question\":\"What did the review conclude about how IUS should be used in practice?\",\"answer\":\"Findings support incorporating IUS into early treatment-response algorithms, while emphasizing the need for standardized cut-offs and multicenter validation.\"}]","Transabdominal Intestinal Ultrasonography in Monitoring and Predicting Outcomes in Ulcerative Colitis - A Systematic Review | PDF",1790761897,43]