{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T18:16:50Z","timestamp":1790792210851,"version":"4.1.0"},"reference-count":20,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T00:00:00Z","timestamp":1765152000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Foundation of Pediatric Research","award":["240050"],"award-info":[{"award-number":["240050"]}]},{"name":"State funding for university-level health research, Tampere University Hospital, Wellbeing services county of Pirkanmaa","award":["T63344\/50621"],"award-info":[{"award-number":["T63344\/50621"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Intestinal ultrasonography (IUS) is a noninvasive tool for assessing bowel inflammation. In adults, a bowel wall thickness (BWT) cutoff of 0.30\u2009cm is used to indicate inflammation, but children do not have a widely accepted value. We propose an optimal BWT cutoff value for children.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed 144 IUS examinations during 2019-2024 in 133 children within 30\u2009days before to 7\u2009days after colonoscopy. Assessed values for the BWT from the terminal ileum to the rectum were paired with colonoscopy findings at each segment (n\u2009=\u2009809 pairs). The cutoff value for detecting inflammation was explored with receiver operating characteristic (ROC) analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In children \u22656\u2009years old IUS demonstrated excellent accuracy for detecting moderate\/severe inflammation (area under the curve [AUC] 0.907) but poor accuracy for mild inflammation (AUC 0.690) or in children &amp;lt;6\u2009years old (AUC, 0.667). The adult cutoff (0.30\u2009cm) missed 32% of inflammation in children. In children \u22656\u2009years old, a BWT cutoff of 0.27\u2009cm detected 85% of moderate\/severe and 43% of mild inflammation. Lower cutoff values (0.24\u2009cm) were more optimal for girls and children weighing &amp;lt;40\u2009kg.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Although IUS is an excellent tool for detecting moderate\/severe bowel inflammation, this method showed limited accuracy in children &amp;lt;6\u2009years old. The adult BWT cutoff missed over 30% of bowel inflammation in children. BWT cutoff of 0.27-0.30\u2009cm in boys and 0.23-0.25\u2009cm in girls and\/or children &amp;lt;40\u2009kg indicated active gut inflammation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ibd\/izaf298","type":"journal-article","created":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T13:05:04Z","timestamp":1762520704000},"page":"730-739","source":"Crossref","is-referenced-by-count":5,"title":["Bowel Wall Thickness Cutoff Value for Assessing Inflammatory Bowel Disease Activity Using Intestinal Ultrasonography in Children"],"prefix":"10.1093","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4892-5710","authenticated-orcid":false,"given":"Laura","family":"R\u00e4is\u00e4nen","sequence":"first","affiliation":[{"name":"Tampere University Tampere Center for Child, Adolescent, and Maternal Health Research, Faculty of Medicine and Health Technology, , Tampere,","place":["Finland"]},{"name":"Tampere University Hospital Department of Paediatrics, Wellbeing Services County of Pirkanmaa, , Tampere,","place":["Finland"]},{"name":"Queensland Children\u2019s Hospital Department of Gastroenterology, Hepatology, and Liver Transplant, , Brisbane, Queensland,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ray","family":"Lang","sequence":"additional","affiliation":[{"name":"Queensland Children\u2019s Hospital Department of Gastroenterology, Hepatology, and Liver Transplant, , Brisbane, Queensland,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Couper","sequence":"additional","affiliation":[{"name":"Women and Children\u2019s Hospital Paediatric Medicine, Gastroenterology, , Adelaide, South Australia,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Lewindon","sequence":"additional","affiliation":[{"name":"Queensland Children\u2019s Hospital Department of Gastroenterology, Hepatology, and Liver Transplant, , Brisbane, Queensland,","place":["Australia"]},{"name":"University of Queensland Queensland Children\u2019s Medical Research Institute, , Brisbane, Queensland,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,12,8]]},"reference":[{"key":"2026040214064296900_izaf298-B1","doi-asserted-by":"crossref","first-page":"2741","DOI":"10.3748\/wjg.v24.i25.2741","article-title":"Current global trends in the incidence of pediatric-onset inflammatory bowel disease","volume":"24","author":"S\u00fdkora","year":"2018","journal-title":"World J Gastroenterol"},{"key":"2026040214064296900_izaf298-B2","doi-asserted-by":"crossref","first-page":"1598","DOI":"10.1093\/ecco-jcc\/jjac072","article-title":"Intestinal ultrasound early on in treatment follow-up predicts endoscopic response to anti-TNF\u03b1 treatment in Crohn\u2019s disease","volume":"16","author":"De Voogd","year":"2022","journal-title":"J Crohns Colitis"},{"key":"2026040214064296900_izaf298-B3","doi-asserted-by":"crossref","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":"Novak","year":"2021","journal-title":"J Crohns Colitis"},{"key":"2026040214064296900_izaf298-B4","doi-asserted-by":"crossref","first-page":"1264","DOI":"10.1093\/ecco-jcc\/jjab002","article-title":"Intestinal ultrasound to assess disease activity in ulcerative colitis: development of a novel UC-ultrasound index","volume":"15","author":"Bots","year":"2021","journal-title":"J Crohns Colitis"},{"key":"2026040214064296900_izaf298-B5","doi-asserted-by":"crossref","first-page":"783","DOI":"10.1093\/ibd\/izab125","article-title":"Intestinal ultrasound in pediatric inflammatory bowel disease: promising, but work in progress","volume":"28","author":"Van Wassenaer","year":"2022","journal-title":"Inflamm Bowel Dis"},{"key":"2026040214064296900_izaf298-B6","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1016\/S0022-3476(97)70325-1","article-title":"Ultrasonographic assessment of inflammatory bowel disease in children: comparison with ileocolonoscopy","volume":"130","author":"Faure","year":"1997","journal-title":"J Pediatr"},{"key":"2026040214064296900_izaf298-B7","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1016\/j.jpeds.2014.02.055","article-title":"Ultrasonography of the colon in pediatric ulcerative colitis: a prospective, blind, comparative study with colonoscopy","volume":"165","author":"Civitelli","year":"2014","journal-title":"J Pediatr"},{"key":"2026040214064296900_izaf298-B8","doi-asserted-by":"crossref","first-page":"795","DOI":"10.1097\/MPG.0000000000000239","article-title":"ESPGHAN revised Porto criteria for the diagnosis of inflammatory bowel disease in children and adolescents","volume":"58","author":"Levine","year":"2014","journal-title":"J Pediatr Gastroenterol Nutr"},{"key":"2026040214064296900_izaf298-B9","doi-asserted-by":"crossref","first-page":"1850","DOI":"10.1097\/MIB.0000000000000131","article-title":"A systematic review of measurement of endoscopic disease activity and mucosal healing in Crohn\u02bcs disease: recommendations for clinical trial design","volume":"20","author":"Khanna","year":"2014","journal-title":"Inflamm Bowel Dis"},{"key":"2026040214064296900_izaf298-B10","doi-asserted-by":"crossref","first-page":"2081","DOI":"10.1093\/ibd\/izae213","article-title":"Evaluation of Crohn\u2019s disease activity: validation of a segmental simple ultrasound score in a multicenter study","volume":"31","author":"Ripoll\u00e9s","year":"2025","journal-title":"Inflamm Bowel Dis"},{"key":"2026040214064296900_izaf298-B11","doi-asserted-by":"crossref","first-page":"jjaf107","DOI":"10.1093\/ecco-jcc\/jjaf107","article-title":"ECCO-ESGAR-ESP-IBUS guideline on diagnostics and monitoring of patients with inflammatory bowel disease: part 2","volume":"19","author":"Yanai","year":"2025","journal-title":"J Crohns Colitis"},{"key":"2026040214064296900_izaf298-B12","doi-asserted-by":"publisher","first-page":"207","DOI":"10.11919\/j.issn.1002-0829.218052","author":"Li","year":"2018"},{"key":"2026040214064296900_izaf298-B13","doi-asserted-by":"crossref","first-page":"947","DOI":"10.1007\/s00247-006-0245-8","article-title":"Sonographic evaluation of inflammatory bowel disease: a prospective, blinded, comparative study","volume":"36","author":"Bremner","year":"2006","journal-title":"Pediatr Radiol"},{"key":"2026040214064296900_izaf298-B14","doi-asserted-by":"crossref","first-page":"402","DOI":"10.1093\/ibd\/izad083","article-title":"Bedside intestinal ultrasound predicts disease severity and the disease distribution of pediatric patients with inflammatory bowel disease: a pilot cross-sectional study","volume":"30","author":"Chavannes","year":"2024","journal-title":"Inflamm Bowel Dis"},{"key":"2026040214064296900_izaf298-B15","doi-asserted-by":"crossref","first-page":"804","DOI":"10.1093\/ecco-jcc\/jjab216","article-title":"Paediatric ulcerative colitis is a fibrotic disease and is linked with chronicity of inflammation","volume":"16","author":"Gordon","year":"2022","journal-title":"J Crohns Colitis"},{"key":"2026040214064296900_izaf298-B16","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1093\/jcag\/gwz047.170","article-title":"Magnetic resonance imaging in children with early onset inflammatory bowel disase\u2014a retrospective cohort study","volume":"3","author":"Eindor","year":"2020","journal-title":"J Can Assoc Gastroenterol"},{"key":"2026040214064296900_izaf298-B17","doi-asserted-by":"crossref","first-page":"820","DOI":"10.1093\/ibd\/izz259","article-title":"Very early onset inflammatory bowel disease: a clinical approach with a focus on the role of genetics and underlying immune deficiencies","volume":"26","author":"Ouahed","year":"2020","journal-title":"Inflamm Bowel Dis"},{"key":"2026040214064296900_izaf298-B18","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1002\/jpn3.70049","article-title":"Defining normal bowel wall thickness in children with inflammatory bowel disease in deep remission: a multicenter study on behalf of the pediatric committee of the International Bowel Ultrasound Group (IBUS)","volume":"81","author":"Kellar","year":"2025","journal-title":"J Pediatr Gastroenterol Nutr"},{"key":"2026040214064296900_izaf298-B19","doi-asserted-by":"crossref","first-page":"973","DOI":"10.1136\/gutjnl-2017-315655","article-title":"Gastrointestinal ultrasound in inflammatory bowel disease: an underused resource with potential paradigm-changing application","volume":"67","author":"Bryant","year":"2018","journal-title":"Gut"},{"key":"2026040214064296900_izaf298-B20","doi-asserted-by":"crossref","first-page":"101382","DOI":"10.1016\/j.imu.2023.101382","article-title":"A comparison of imputation methods for categorical data","volume":"42","author":"Memon","year":"2023","journal-title":"Inform Med Unlocked"}],"container-title":["Inflammatory Bowel Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ibdjournal\/article-pdf\/32\/4\/730\/65800214\/izaf298.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ibdjournal\/article-pdf\/32\/4\/730\/65800214\/izaf298.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T18:06:53Z","timestamp":1775153213000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ibdjournal\/article\/32\/4\/730\/8373826"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,8]]},"references-count":20,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2025,12,8]]},"published-print":{"date-parts":[[2026,4,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ibd\/izaf298","relation":{},"ISSN":["1078-0998","1536-4844"],"issn-type":[{"value":"1078-0998","type":"print"},{"value":"1536-4844","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,4]]},"published":{"date-parts":[[2025,12,8]]}}}