{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T18:27:44Z","timestamp":1793212064805,"version":"4.5.0"},"reference-count":40,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2023,8,1]],"date-time":"2023-08-01T00:00:00Z","timestamp":1690848000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,8,1]],"date-time":"2023-08-01T00:00:00Z","timestamp":1690848000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur Radiol"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Objectives<\/jats:title>\n                <jats:p>The simple ultrasound activity score for Crohn\u2019s disease (SUS-CD) and bowel ultrasound score (BUSS) are promising intestinal ultrasound (IUS) indices of CD, but studied mainly in small settings with few sonographers. We compared SUS-CD and BUSS against histological and magnetic resonance enterography (MRE) reference standards in a post hoc analysis of a prospective multicentre, multireader trial.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Participants recruited to the METRIC trial (ISRCTN03982913) were studied, including those with available terminal ileal (TI) biopsies. Sensitivity and specificity of SUS-CD and BUSS for TI CD activity were calculated with 95% confidence intervals (CI), from the prospective observations of the original METRIC trial sonographers against the histological activity index (HAI) and the simplified magnetic resonance index of activity (sMARIA).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>We included 284 patients (median 31.5 years, IQR 23\u201346) from 8 centres, who underwent IUS and MRE. Of these, 111 patients had available terminal ileal biopsies with HAI scoring. Against histology, sensitivity and specificity for active disease were 79% (95% CI 69\u201386%) and 50% (31\u201369%) for SUS-CD, and 66% (56\u201375%) and 68% (47\u201384%) for BUSS, respectively. Compared to sMARIA, the sensitivity and specificity for active CD were 81% (74\u201386%) and 75% (66\u201383%) for SUS-CD, and 68% (61\u201374%) and 85% (76\u201391%) for BUSS, respectively. The sensitivity of SUS-CD was significantly greater than that of BUSS against HAI and sMARIA (<jats:italic>p\u00a0<\/jats:italic>&lt; 0.001), but its specificity was significantly lower than of BUSS against the MRE reference standard (<jats:italic>p\u00a0<\/jats:italic>= 0.003).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Particularly when compared to MRE activity scoring, SUS-CD and BUSS are promising tools in a real-world clinical setting.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Clinical relevance statement<\/jats:title>\n                <jats:p>When tested using data from a multicentre, multireader diagnostic accuracy trial, the simple ultrasound activity score for Crohn\u2019s disease (SUS-CD) and bowel ultrasound score (BUSS) were clinically viable intestinal ultrasound indices that were reasonably sensitive and specific for terminal ileal Crohn\u2019s disease, especially when compared to a magnetic resonance reference standard.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Key Points<\/jats:title>\n                <jats:p><jats:list list-type=\"bullet\">\n                  <jats:list-item>\n                    <jats:p><jats:italic>The simple ultrasound activity score for Crohn\u2019s disease and bowel ultrasound score are promising intestinal ultrasound indices of Crohn\u2019s disease but to date studied mainly in small settings with few sonographers.<\/jats:italic><\/jats:p>\n                  <\/jats:list-item>\n                  <jats:list-item>\n                    <jats:p><jats:italic>Compared to histology and the magnetic resonance reference standard in a multicentre, multireader setting, the sensitivity of simple ultrasound activity score for Crohn\u2019s disease is significantly greater than that of bowel ultrasound score.<\/jats:italic><\/jats:p>\n                  <\/jats:list-item>\n                  <jats:list-item>\n                    <jats:p><jats:italic>The specificity of simple ultrasound activity score for Crohn\u2019s disease was significantly lower than that of bowel ultrasound score compared to the magnetic resonance enterography reference standard. The specificity of both indices was numerically higher when the magnetic resonance enterography reference standard was adopted.<\/jats:italic><\/jats:p>\n                  <\/jats:list-item>\n                <\/jats:list><\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00330-023-09958-6","type":"journal-article","created":{"date-parts":[[2023,8,1]],"date-time":"2023-08-01T11:01:53Z","timestamp":1690887713000},"page":"455-464","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Diagnostic performance of sonographic activity scores for adult terminal ileal Crohn\u2019s disease compared to magnetic resonance and histological reference standards: experience from the METRIC trial"],"prefix":"10.1007","volume":"34","author":[{"given":"Shankar","family":"Kumar","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Parry","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sue","family":"Mallett","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Plumb","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gauraang","family":"Bhatnagar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Beable","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret","family":"Betts","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gillian","family":"Duncan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arun","family":"Gupta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antony","family":"Higginson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Hyland","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roger","family":"Lapham","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uday","family":"Patel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Pilcher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Slater","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Damian","family":"Tolan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian","family":"Zealley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steve","family":"Halligan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6765-8806","authenticated-orcid":false,"given":"Stuart A.","family":"Taylor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"METRIC study group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,8,1]]},"reference":[{"key":"9958_CR1","doi-asserted-by":"crossref","unstructured":"Colombel JF, Panaccione R, Bossuyt P et al (2017) Effect of tight control management on Crohn\u2019s disease (CALM): a multicentre, randomised, controlled phase 3 trial. 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The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"One of the authors has significant statistical expertise.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Statistics and biometry"}},{"value":"Written informed consent was obtained from all subjects (patients) in this study.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"Institutional Review Board approval was obtained.","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"A subset of 111 patients from this study have been reported in Kumar S, Parry T, Mallett S et al (2022) Diagnostic performance of magnetic resonance enterography disease activity indices compared with a histological reference standard for adult terminal ileal Crohn\u2019s disease: experience from the METRIC trial. J Crohns Colitis 2022 ;16(10):1531-1539. doi: 10.1093\/ecco-jcc\/jjac062. This article evaluated the diagnostic performance of magnetic resonance enterography activity scores.","order":7,"name":"Ethics","group":{"name":"EthicsHeading","label":"Study subjects or cohorts overlap"}},{"order":8,"name":"Ethics","group":{"name":"EthicsHeading","label":"Methodology"}}]}}