{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T23:21:49Z","timestamp":1783034509303,"version":"3.54.6"},"reference-count":21,"publisher":"Georg Thieme Verlag KG","funder":[{"name":"Samsung Medison Research Collaboration"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Ultraschall Med"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Intestinal ultrasound (IUS) is used to assess and monitor inflammatory bowel disease (IBD). Bowel wall thickness (BWT) is its key marker, but accurate measurement is operator-dependent and requires expertise. Artificial intelligence (AI) may reduce variability and support IUS implementation. We developed and validated an AI model to detect bowel wall layers and measure BWT.<\/jats:p>\n                  <jats:p>We developed a deep learning system (BowelAssist, BA) based on a pretrained convolutional neural network. A dataset of 9000 images (711 patients, 421 IBD) was used for training (80%), validation (10%), and testing (10%). Ground-truth annotations of bowel wall layers for 3000 segments were provided by an expert sonographer. External validation was performed live in 35 patients (67 bowel segments), with additional blinded evaluation by a trained operator in 19 (30 segments). BA performance, including BWT measurement, wall-layer recognition, and intra- and inter-observer agreement, was compared with manual measurements using Pearson\u2019s correlation and Bland-Altman analysis.<\/jats:p>\n                  <jats:p>BA analysis was feasible in 94.7% of measurements. It showed excellent agreement with manual BWT measurements (r=0.88 for cross-sectional and r=0.77 for longitudinal scans), and low mean absolute errors (&lt;0.45mm). The sensitivity and specificity for detecting pathological BWT were 83.6% and 95.7%, respectively. The intra-observer reproducibility of BA measurements was &gt;0.90  and the inter-observer reproducibility between expert and trained operators was 0.53 for cross-sectional and 0.57 for longitudinal scans. Stratification recognition showed sensitivity of 90.1% and specificity of 83.8%.<\/jats:p>\n                  <jats:p>An AI-based model provides accurate, reproducible assessment of BWT supporting its integration into clinical and research workflows for objective evaluation of IBD activity.<\/jats:p>","DOI":"10.1055\/a-2870-0924","type":"journal-article","created":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T22:46:26Z","timestamp":1778193986000},"source":"Crossref","is-referenced-by-count":0,"title":["Development and Clinical Validation of an Automated Artificial Intelligence System for Bowel Wall Thickness Assessment in Adult Inflammatory Bowel Diseases"],"prefix":"10.1055","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0810-4026","authenticated-orcid":false,"given":"Giovanni","family":"Maconi","sequence":"additional","affiliation":[{"name":"Luigi Sacco University Hospital, Lombardy, Italy","place":["Milan"],"department":["Gastroenterology Unit, Department of Biomedical and Clinical Sciences"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davide Giuseppe","family":"Cassella","sequence":"additional","affiliation":[{"name":"Luigi Sacco University Hospital, Lombardy, Italy","place":["Milan"],"department":["Gastroenterology Unit, Department of Biomedical and Clinical Sciences"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriele","family":"Natalello","sequence":"additional","affiliation":[{"name":"Luigi Sacco University Hospital, Lombardy, Italy","place":["Milan"],"department":["Gastroenterology Unit, Department of Biomedical and Clinical Sciences"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonella","family":"Marra","sequence":"additional","affiliation":[{"name":"IRCCS Ospedale Casa Sollievo della Sofferenza, Italy","place":["San Giovanni Rotondo"],"department":["Gastroenterology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Cataletti","sequence":"additional","affiliation":[{"name":"Luigi Sacco University Hospital, Lombardy, Italy","place":["Milan"],"department":["Gastroenterology Unit, Department of Biomedical and Clinical Sciences"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2875-6753","authenticated-orcid":false,"given":"Pradeep Kumar","family":"Anand","sequence":"additional","affiliation":[{"name":"Samsung Group, Seoul, Korea (the Republic of)","place":["Seoul"],"department":["Clinical Research Group, Samsung Healthcare"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,7,2]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1476","DOI":"10.1053\/j.gastro.2021.10.052","article-title":"Point of care testing and home testing: pragmatic considerations for widespread incorporation of stool tests, serum tests, and intestinal ultrasound","volume":"162","author":"R Wilkens","year":"2022","journal-title":"Gastroenterology"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"304","DOI":"10.1055\/s-0043-125329","article-title":"EFSUMB Recommendations and Clinical Guidelines for Intestinal Ultrasound (GIUS) in Inflammatory Bowel Diseases","volume":"39","author":"G Maconi","year":"2018","journal-title":"Ultraschall in Med"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1002\/ueg2.12196","article-title":"Ultrasonography in inflammatory bowel disease so far we are?","volume":"10","author":"C Maaser","year":"2022","journal-title":"United European Gastroenterol J"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"609","DOI":"10.1093\/ecco-jcc\/jjaa216","article-title":"Expert consensus on optimal acquisition and development of the international bowel ultrasound segmental activity score [IBUS-SAS]: a reliability and inter-rater variability study on intestinal ultrasonography in Crohn\u2019s disease","volume":"15","author":"KL Novak","year":"2021","journal-title":"J Crohns Colitis"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1148\/radiol.2471070611","article-title":"Inflammatory bowel disease diagnosed with US, MR, scintigraphy, and CT: meta-analysis of prospective studies","volume":"247","author":"K Horsthuis","year":"2008","journal-title":"Radiology"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"1926","DOI":"10.3390\/diagnostics11101926","article-title":"Diagnostic Accuracy of Non-Invasive Imaging for Detection of Colonic Inflammation in Patients with Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis","volume":"11","author":"MT Alshammari","year":"2021","journal-title":"Diagnostics (Basel)"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"554","DOI":"10.1093\/ecco-jcc\/jjab173","article-title":"Defining transabdominal intestinal ultrasound treatment response and remission in inflammatory bowel disease: systematic review and expert consensus statement","volume":"16","author":"JFKF Ilvemark","year":"2022","journal-title":"J Crohns Colitis"},{"issue":"08","key":"ref8","doi-asserted-by":"publisher","first-page":"873","DOI":"10.1111\/apt.16288","article-title":"Standardisation of intestinal ultrasound scoring in clinical trials for luminal Crohn\u2019s disease","volume":"53","author":"TM Goodsall","year":"2021","journal-title":"Aliment Pharmacol Ther"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1111\/apt.16892","article-title":"Toward transmural healing: sonographic healing is associated with improved long-term outcomes in patients with Crohn\u2019s disease","volume":"56","author":"R Vaughan","year":"2022","journal-title":"Aliment Pharmacol Ther"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"1629","DOI":"10.1136\/gutjnl-2019-319451","article-title":"Intestinal ultrasound for monitoring therapeutic response in patients with ulcerative colitis: results from the TRUST&UC study","volume":"69","author":"C Maaser","year":"2020","journal-title":"Gut"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1016\/j.cgh.2022.05.055","article-title":"STARDUST intestinal ultrasound study group. Early ultrasound response and progressive transmural remission after treatment with ustekinumab in crohn\u2019s disease","volume":"21","author":"T Kucharzik","year":"2023","journal-title":"Clin Gastroenterol Hepatol"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"1511","DOI":"10.1016\/j.dld.2024.01.192","article-title":"The learning curve for using intestinal ultrasonography","volume":"56","author":"C Bezzio","year":"2024","journal-title":"Dig Liver Dis"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"1280","DOI":"10.1097\/MEG.0000000000002253","article-title":"Interrater reliability of the assessment of disease activity by gastrointestinal ultrasound in a prospective cohort of patients with inflammatory bowel disease","volume":"33","author":"RL Smith","year":"2021","journal-title":"Eur J Gastroenterol Hepatol"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"1600","DOI":"10.1016\/j.cgh.2024.08.007","article-title":"Reliability of Intestinal Ultrasound for Evaluating Crohn\u02bcs Disease Activity Using Point-of-care and Central Reading","volume":"23","author":"TM Goodsall","year":"2025","journal-title":"Clin Gastroenterol Hepatol"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"1121","DOI":"10.1016\/j.gie.2020.08.024","article-title":"Application of artificial intelligence using a novel EUS-based convolutional neural network model to identify and distinguish benign and malignant hepatic masses","volume":"93","author":"NB Marya","year":"2021","journal-title":"Gastrointest Endosc"},{"issue":"06","key":"ref16","doi-asserted-by":"crossref","first-page":"e0251701","DOI":"10.1371\/journal.pone.0251701","article-title":"Real-time computeraided diagnosis of focal pancreatic masses from endoscopic ultrasound imaging based on a hybrid convolutional and long short-term memory neural network model","volume":"16","author":"AL Udri\u0219toiu","year":"2021","journal-title":"PLoS One"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"1901","DOI":"10.1093\/ibd\/izad014","article-title":"Automatized Detection of Crohn\u02bcs Disease in Intestinal Ultrasound Using Convolutional Neural Network","volume":"29","author":"D Carter","year":"2023","journal-title":"Inflamm Bowel Dis"},{"issue":"04","key":"ref18","doi-asserted-by":"publisher","first-page":"jjaf037","DOI":"10.1093\/ecco-jcc\/jjaf037","article-title":"Artificial intelligence-assisted approach to assessing bowel wall thickness in pediatric inflammatory bowel disease using intestinal ultrasound images","volume":"19","author":"L Kumaralingam","year":"2025","journal-title":"J Crohns Colitis"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"e1","DOI":"10.1055\/s-0042-115853","article-title":"EFSUMB Recommendations and Guidelines for Gastrointestinal Ultrasound","volume":"38","author":"K Nylund","year":"2017","journal-title":"Ultraschall in Med"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2025.07.024","article-title":"The EXTENT Study: Results From an International Expert Delphi Consensus to Define Ultrasonographic Parameters for Measuring Bowel Damage in Crohn\u02bcs Disease","author":"C Palmela","year":"2025","journal-title":"Clin Gastroenterol Hepatol"},{"key":"ref21","doi-asserted-by":"crossref","first-page":"2001","DOI":"10.1093\/ibd\/izy091","article-title":"Real-time Interobserver Agreement in Bowel Ultrasonography for Diagnostic Assessment in Patients With Crohn\u02bcs Disease: An International Multicenter Study","volume":"24","author":"E Calabrese","year":"2018","journal-title":"Inflamm Bowel Dis"}],"container-title":["Ultraschall in der Medizin - European Journal of Ultrasound"],"original-title":[],"language":"de","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2870-0924.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T23:12:10Z","timestamp":1783033930000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2870-0924"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,7]]},"references-count":21,"URL":"https:\/\/doi.org\/10.1055\/a-2870-0924","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0172-4614","1438-8782"],"issn-type":[{"value":"0172-4614","type":"print"},{"value":"1438-8782","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,5,7]]},"published":{"date-parts":[[2026,5,7]]}}}