{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T23:49:51Z","timestamp":1785196191235,"version":"3.55.0"},"reference-count":115,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2024,7,16]],"date-time":"2024-07-16T00:00:00Z","timestamp":1721088000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Chronic inflammatory bowel diseases, such as Crohn\u2019s disease and ulcerative colitis, present diagnostic challenges due to their complex and heterogeneous nature. While histology remains fundamental for accurate diagnosis, a multidisciplinary approach incorporating clinical, endoscopic, and imaging modalities is increasingly recognized as essential for comprehensive evaluation. This article delves into the importance of integrating various diagnostic techniques in the assessment of IBD. Colonoscopy and histology, with its ability to directly visualize the intestinal mucosa, play a central role in the diagnostic process. However, histological analysis alone may not suffice, necessitating the inclusion of advanced imaging techniques, such as magnetic resonance enterography (MRE), computed tomography enterography (CTE), and intestinal ultrasound (IUS). These techniques provide valuable insights into the disease\u2019s extent, severity, and complications, and should be used in conjunction with biochemical parameters. These modalities complement traditional endoscopic and histological findings, offering a more holistic understanding of the disease process. A multidisciplinary approach that incorporates clinical, endoscopic, histological, serological, and imaging assessments enables clinicians to achieve a more accurate and timely diagnosis of IBD. Moreover, this integrated approach facilitates personalized treatment strategies tailored to individual patient needs, ultimately improving clinical outcomes and quality of life for those affected by chronic inflammatory bowel diseases.<\/jats:p>","DOI":"10.3390\/diagnostics14141530","type":"journal-article","created":{"date-parts":[[2024,7,16]],"date-time":"2024-07-16T11:12:49Z","timestamp":1721128369000},"page":"1530","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["A Comprehensive Multidisciplinary Approach to Diagnosing Chronic Inflammatory Bowel Diseases: Integration of Clinical, Endoscopic, and Imaging Modalities"],"prefix":"10.3390","volume":"14","author":[{"given":"Clelia","family":"Cicerone","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Endoscopy, IRCCS San Raffaele Hospital, 20132 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8591-6995","authenticated-orcid":false,"given":"Ferdinando","family":"D\u2019Amico","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Endoscopy, IRCCS San Raffaele Hospital, 20132 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariangela","family":"Allocca","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Endoscopy, IRCCS San Raffaele Hospital, 20132 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Zilli","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Endoscopy, IRCCS San Raffaele Hospital, 20132 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tommaso Lorenzo","family":"Parigi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Endoscopy, IRCCS San Raffaele Hospital, 20132 Milan, Italy"},{"name":"Department of Gastroenterology and Endoscopy, Vita-Salute San Raffaele University, 20132 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7341-1351","authenticated-orcid":false,"given":"Silvio","family":"Danese","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Endoscopy, IRCCS San Raffaele Hospital, 20132 Milan, Italy"},{"name":"Department of Gastroenterology and Endoscopy, Vita-Salute San Raffaele University, 20132 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federica","family":"Furfaro","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Endoscopy, IRCCS San Raffaele Hospital, 20132 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,7,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"91","DOI":"10.3748\/wjg.v20.i1.91","article-title":"Inflammatory bowel disease: Pathogenesis","volume":"20","author":"Zhang","year":"2014","journal-title":"World J. Gastroenterol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"144","DOI":"10.1093\/ecco-jcc\/jjy113","article-title":"ECCO-ESGAR Guideline for Diagnostic Assessment in IBD Part 1: Initial diagnosis, monitoring of known IBD, detection of complications","volume":"13","author":"Maaser","year":"2019","journal-title":"J. Crohn\u2019s Colitis"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"514","DOI":"10.1172\/JCI30587","article-title":"The fundamental basis of inflammatory bowel disease","volume":"117","author":"Strober","year":"2007","journal-title":"J. Clin. Investig."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2769","DOI":"10.1016\/S0140-6736(17)32448-0","article-title":"Worldwide incidence and prevalence of inflammatory bowel disease in the 21st century: A systematic review of population-based studies","volume":"390","author":"Ng","year":"2018","journal-title":"Lancet"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1573","DOI":"10.1093\/ecco-jcc\/jjab029","article-title":"The Burden of Inflammatory Bowel Disease in Europe in 2020","volume":"15","author":"Zhao","year":"2021","journal-title":"J. Crohn\u2019s Colitis"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Caviglia, G.P., Garrone, A., Bertolino, C., Vanni, R., Bretto, E., Poshnjari, A., Tribocco, E., Frara, S., Armandi, A., and Astegiano, M. (2023). Epidemiology of Inflammatory Bowel Diseases: A Population Study in a Healthcare District of North-West Italy. J. Clin. Med., 13.","DOI":"10.3390\/jcm12020641"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"401","DOI":"10.17235\/reed.2016.4176\/2015","article-title":"Meta-analysis of the association between appendiceal orifice inflammation and appendectomy and ulcerative colitis","volume":"108","author":"Deng","year":"2016","journal-title":"Rev. Esp. Enferm. Dig."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"2925","DOI":"10.1111\/j.1572-0241.2008.02118.x","article-title":"The risk of developing Crohn\u2019s disease after an appendectomy: A meta-analysis","volume":"103","author":"Kaplan","year":"2008","journal-title":"Am. J. Gastroenterol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2687","DOI":"10.1038\/ajg.2010.398","article-title":"Association between the use of antibiotics in the first year of life and pediatric inflammatory bowel disease","volume":"105","author":"Shaw","year":"2010","journal-title":"Am. J. Gastroenterol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"647","DOI":"10.1053\/j.gastro.2019.04.016","article-title":"Environmental risk factors for inflammatory bowel diseases: An umbrella review of meta-analyses","volume":"157","author":"Piovani","year":"2019","journal-title":"Gastroenterology"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"965","DOI":"10.1016\/j.crohns.2012.09.003","article-title":"Second European evidence-based consensus on the diagnosis and management of ulcerative colitis part 1: Definitions and diagnosis","volume":"6","author":"Dignass","year":"2012","journal-title":"J. Crohn\u2019s Colitis"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/j.crohns.2009.12.002","article-title":"The second European evidence-based Consensus on the diagnosis and management of Crohn\u2019s disease: Definitions and diagnosis","volume":"4","author":"Dignass","year":"2010","journal-title":"J. Crohn\u2019s Colitis"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"379","DOI":"10.5217\/ir.2019.09148","article-title":"Fibrostenotic strictures in Crohn\u2019s disease","volume":"18","author":"Yoo","year":"2020","journal-title":"Intest. Res."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1053\/j.gastro.2016.09.047","article-title":"Mechanisms, Management, and Treatment of Fibrosis in Patients with Inflammatory Bowel Diseases","volume":"152","author":"Rieder","year":"2017","journal-title":"Gastroenterology"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1474","DOI":"10.1038\/ajg.2012.260","article-title":"Prevalence of symptoms meeting criteria for irritable bowel syndrome in inflammatory bowel disease: Systematic review and meta-analysis","volume":"107","author":"Halpin","year":"2012","journal-title":"Am. J. Gastroenterol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1518","DOI":"10.1053\/j.gastro.2004.02.072","article-title":"From Symptom to Diagnosis: Clinical Distinctions Among Various Forms of Intestinal Inflammation","volume":"126","author":"Bruce","year":"2004","journal-title":"Gastroenterology"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Zeitz, J., Ak, M., M\u00fcller-Mottet, S., Scharl, S., Biedermann, L., Fournier, N., Frei, P., Pittet, V., Scharl, M., and Fried, M. (2016). Pain in IBD Patients: Very Frequent and Frequently Insufficiently Taken into Account. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0156666"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"515","DOI":"10.2214\/ajr.149.3.515","article-title":"Appendicitis as the initial manifestation of Crohn\u2019s disease: Radiologic features and prognosis","volume":"149","author":"Agha","year":"1987","journal-title":"AJR Am. J. Roentgenol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"888","DOI":"10.12998\/wjcc.v2.i12.888","article-title":"Appendiceal Crohn\u2019s disease clinically presenting as acute appendicitis","volume":"2","author":"Han","year":"2014","journal-title":"World J. Clin. Cases"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1093\/ecco-jcc\/jjy114","article-title":"ECCO-ESGAR Guideline for Diagnostic Assessment in IBD Part 2: IBD scores and general principles and technical aspects","volume":"13","author":"Sturm","year":"2019","journal-title":"J. Crohn\u2019s Colitis"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1093\/ecco-jcc\/jjv213","article-title":"The first European evidence-based consensus on extra-intestinal manifestations in inflammatory bowel disease","volume":"10","author":"Harbord","year":"2016","journal-title":"J. Crohn\u2019s Colitis"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1016\/j.crohns.2009.07.001","article-title":"Frequency of indeterminate colitis in children and adults with IBD\u2014A metaanalysis","volume":"3","author":"Prenzel","year":"2009","journal-title":"J. Crohn\u2019s Colitis."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"S41","DOI":"10.1097\/01.mcg.0000123991.13937.7e","article-title":"Indeterminate colitis: Clinical spectrum of disease","volume":"38","author":"Burakoff","year":"2004","journal-title":"Clin. Gastroenterol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1093\/ecco-jcc\/jjac111","article-title":"Risk Factors for Developing Inflammatory Bowel Disease within and across Families with a Family History of IBD","volume":"27","author":"Torres","year":"2023","journal-title":"J. Crohn\u2019s Colitis"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1791","DOI":"10.1093\/ecco-jcc\/jjad097","article-title":"Autoimmune Pancreatitis in Patients with Inflammatory Bowel Disease: A Real-World Multicentre Collaborative ECCO CONFER Study","volume":"24","author":"Eder","year":"2023","journal-title":"J. Crohn\u2019s Colitis"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"444","DOI":"10.1038\/ajg.2015.6","article-title":"A meta-analysis of the utility of C-reactive protein, erythrocyte sedimentation rate, fecal calprotectin, and fecal lactoferrin to exclude inflammatory bowel disease in adults with IBS","volume":"110","author":"Menees","year":"2015","journal-title":"Am. J. Gastroenterol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1120","DOI":"10.1111\/apt.17754","article-title":"Systematic review with meta-analysis: Diagnostic performance of faecal calprotectin in distinguishing inflammatory bowel disease from irritable bowel syndrome in adults","volume":"58","author":"Dajti","year":"2023","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_28","first-page":"17562848241251600","article-title":"Biomarkers in inflammatory bowel disease: A practical guide","volume":"9","author":"Colugo","year":"2024","journal-title":"Herap Adv. Gastroenterol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"e011041","DOI":"10.1136\/bmjopen-2016-011041","article-title":"Clinical outcomes at 12 months and risk of inflammatory bowel disease in patients with an intermediate raised fecal calprotectin: A \u2018real-world\u2019 view","volume":"6","author":"McFarlane","year":"2016","journal-title":"BMJ Open"},{"key":"ref_30","first-page":"53","article-title":"The level of fecal calprotectin significantly correlates with Clostridium difficile infection severity","volume":"59","author":"Biesiada","year":"2019","journal-title":"Folica Med. Cracov"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1097\/QAI.0000000000002538","article-title":"Fecal calprotectin is elevated in HIV and related to systemic inflammation","volume":"86","author":"Eckard","year":"2021","journal-title":"J. Acquis. Immune Defic. Syndr."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Vieira, A., Fang, C.B., Rolim, E.G., Klug, W.A., Steinwurz, F., Rossini, L.G., and Candel\u00e1ria, P.A. (2009). Inflammatory bowel disease activity assessed by fecal calprotectin and lactoferrin: Correlation with laboratory parameters, clinical, endoscopic and histological indexes. BMC Res. Notes, 2.","DOI":"10.1186\/1756-0500-2-221"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"106859","DOI":"10.1016\/j.phrs.2023.106859","article-title":"Polymorphisms indicating risk of inflammatory bowel disease or antigenicity to anti-TNF drugs as biomarkers of response in children","volume":"194","author":"Velasco","year":"2023","journal-title":"Pharmacol. Res."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1002\/path.4817","article-title":"The genetic background of inflammatory bowel disease: From correlation to causality","volume":"241","author":"Venema","year":"2017","journal-title":"J. Pathol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1101","DOI":"10.1016\/j.gie.2014.10.030","article-title":"American Society for Gastrointestinal Endoscopy Standards of Practice Committee. The role of endoscopy in inflammatory bowel disease","volume":"81","author":"Shergill","year":"2015","journal-title":"Gastrointest. Endosc."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"571","DOI":"10.1136\/gut.2010.224154","article-title":"Guidelines for the management of inflammatory bowel disease in adults","volume":"60","author":"Mowat","year":"2011","journal-title":"Gut"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1084","DOI":"10.1111\/j.1572-0241.2007.01194.x","article-title":"The diagnostic value of endoscopic terminal ileum biopsies","volume":"102","author":"McHugh","year":"2007","journal-title":"Am. J. Gastroenterol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1016\/0016-5085(87)90856-0","article-title":"Colonoscopy in inflammatory bowel disease. Diagnostic accuracy and proposal of an endoscopic score","volume":"92","author":"Pera","year":"1987","journal-title":"Gastroenterology"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"653","DOI":"10.1097\/MPG.0b013e31805563f3","article-title":"Differentiating ulcerative colitis from Crohn disease in children and young adults: Report of a working group of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition and the Crohn\u2019s and Colitis Foundation of America","volume":"44","author":"Gastroenterology","year":"2007","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"2050","DOI":"10.1007\/s10620-014-3129-z","article-title":"Appendiceal skip inflammation and ulcerative colitis","volume":"59","author":"Park","year":"2014","journal-title":"Dig. Dis. Sci."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"O278","DOI":"10.1111\/codi.13435","article-title":"Appendiceal orifice inflammation is associated with proximal extension of disease in patients with ulcerative colitis","volume":"18","author":"Anzai","year":"2016","journal-title":"Colorectal Dis."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"689","DOI":"10.1097\/PAS.0b013e3181db84cd","article-title":"Rectal sparing and skip lesions in ulcerative colitis: A comparative study of endoscopic and histologic findings in patients who underwent proctocolectomy","volume":"34","author":"Joo","year":"2010","journal-title":"Am. J. Surg. Pathol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"2038","DOI":"10.1007\/s10350-005-0160-3","article-title":"Ileitis in ulcerative colitis: Is it a backwash?","volume":"48","author":"Abdelrazeq","year":"2005","journal-title":"Dis. Colon. Rectum."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1287","DOI":"10.1002\/ibd.20398","article-title":"Endoscopic evaluation of patients with inflammatory bowel disease","volume":"14","author":"Simpson","year":"2008","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1309\/UAXMW3428PGN9HJ3","article-title":"Contemporary morphologic definition of backwash ileitis in ulcerative colitis and features that distinguish it from Crohn disease","volume":"126","author":"Goldstein","year":"2006","journal-title":"Am. J. Clin. Pathol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1618","DOI":"10.1007\/s10620-012-2072-0","article-title":"Upper gastrointestinal involvement of Crohn\u2019s disease: A prospective study on the role of upper endoscopy in the diagnostic work-up","volume":"57","author":"Annunziata","year":"2012","journal-title":"Dig. Dis. Sci."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1093\/ecco-jcc\/jjad142","article-title":"Definitions of Histological Abnormalities in Inflammatory Bowel Disease: An ECCO Position Paper","volume":"18","author":"RFeakins","year":"2024","journal-title":"J. Crohn\u2019s Colitis"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1004","DOI":"10.1055\/s-2003-44593","article-title":"Diagnosing colitis: A prospective study on essential parameters for reaching a diagnosis","volume":"35","author":"Dejaco","year":"2003","journal-title":"Endoscopy"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1005","DOI":"10.1136\/jclinpath-2013-201885","article-title":"Inflammatory bowel disease biopsies: Updated British Society of Gastroenterology reporting guidelines British Society of Gastroenterology","volume":"66","author":"Feakins","year":"2013","journal-title":"J. Clin. Pathol."},{"key":"ref_50","first-page":"93","article-title":"Guidelines for the initial biopsy diagnosis of suspected chronic idiopathic inflammatory bowel disease","volume":"50","author":"Jenkins","year":"1997","journal-title":"Br. Soc. Gastroenterol. Initiat. J. Clin. Pathol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"966","DOI":"10.1097\/00000478-198911000-00008","article-title":"Normal histology of the colon","volume":"13","author":"Levine","year":"1989","journal-title":"Am. J. Surg. Pathol."},{"key":"ref_52","first-page":"305","article-title":"Gastrointestinal immunology: Cell types in the lamina propria\u2014A morphological review","volume":"87","author":"Hunyady","year":"2000","journal-title":"Acta Physiol. Hung."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"832","DOI":"10.1016\/j.humpath.2007.10.012","article-title":"Evaluation of site-specific and seasonal variation in colonic mucosal eosinophils","volume":"39","author":"Polydorides","year":"2008","journal-title":"Hum. Pathol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1016\/0016-5085(84)90595-X","article-title":"Rectal biopsy helps to distinguish acute self-limited colitis from idiopathic inflammatory bowel disease","volume":"86","author":"Surawicz","year":"1984","journal-title":"Gastroenterology"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"i1","DOI":"10.1136\/gut.2005.081950a","article-title":"European evidence based consensus on the diagnosis and management of Crohn\u2019s disease: Definitions and diagnosis","volume":"55","author":"Stange","year":"2006","journal-title":"Gut"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"755","DOI":"10.1016\/0016-5085(94)90124-4","article-title":"Mucosal biopsy diagnosis of colitis: Acute self-limited colitis and idiopathic inflammatory bowel disease","volume":"107","author":"Surawicz","year":"1994","journal-title":"Gastroenterology"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"318","DOI":"10.3109\/00365529409094843","article-title":"A prospective study of first attacks of inflammatory bowel disease and infectious colitis. Histologic course during the first year after presentation","volume":"29","author":"Schumacher","year":"1994","journal-title":"Scand. J. Gastroenterol."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"961","DOI":"10.1136\/gut.35.7.961","article-title":"Observer variation and discriminatory value of biopsy features in inflammatory bowel disease","volume":"35","author":"Theodossi","year":"1994","journal-title":"Gut"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1136\/jcp.55.1.51","article-title":"Discriminant histological features in the diagnosis of chronic idiopathic inflammatory bowel disease: Analysis of a large dataset by a novel data visualisation technique","volume":"55","author":"Cross","year":"2002","journal-title":"J. Clin. Pathol."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1016\/0016-5085(87)90124-7","article-title":"Histopathology differentiates acute self-limited colitis from ulcerative colitis","volume":"92","author":"Nostrant","year":"1987","journal-title":"Gastroenterology"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1016\/j.gtc.2006.07.004","article-title":"Chromoendoscopy and other novel imaging techniques","volume":"35","author":"Kiesslich","year":"2006","journal-title":"Gastroenterol. Clin. N. Am."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"e36836","DOI":"10.1097\/MD.0000000000036836","article-title":"High-definition chromoendoscopy results in more significant dysplasia detection than white light endoscopy with random biopsies in ulcerative colitis patients: A single-center retrospective study","volume":"103","author":"Hoang","year":"2024","journal-title":"Medicine"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"63","DOI":"10.3748\/wjg.v17.i1.63","article-title":"New endoscopic approaches in IBD","volume":"17","author":"Neumann","year":"2011","journal-title":"World J. Gastroenterol."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"1043","DOI":"10.3748\/wjg.v16.i9.1043","article-title":"Novel image-enhanced endoscopy with i-scan technology","volume":"16","author":"Kodashima","year":"2010","journal-title":"World J. Gastroenterol."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"957","DOI":"10.1016\/j.gie.2007.04.014","article-title":"Magnifying colonoscopy with narrow band imaging system for the diagnosis of dysplasia in ulcerative colitis: A pilot study","volume":"66","author":"Matsumoto","year":"2007","journal-title":"Gastrointest. Endosc."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"562","DOI":"10.1136\/gutjnl-2017-315235","article-title":"Advanced endoscopic techniques in the assessment of inflammatory bowel disease: New technology, new era","volume":"68","author":"Iacucci","year":"2019","journal-title":"Gut"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.gie.2011.01.061","article-title":"GI endoscopes","volume":"74","author":"Varadarajulu","year":"2011","journal-title":"Gastrointest. Endosc."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1016\/j.gie.2014.06.020","article-title":"Electronic chromoendoscopy","volume":"81","author":"Manfredi","year":"2015","journal-title":"Gastrointest. Endosc."},{"key":"ref_69","first-page":"1935","article-title":"Virtual chromoendoscopy for prediction of severity and disease extent in patients with inflammatory bowel disease: A randomized controlled study","volume":"19","author":"Neumann","year":"2013","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"706","DOI":"10.1053\/j.gastro.2004.06.050","article-title":"Confocal laser endoscopy for diagnosing intraepithelial neoplasia and colorectal cancer in vivo","volume":"127","author":"Kiesslich","year":"2004","journal-title":"Gastroenterology"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"S286","DOI":"10.1111\/j.1440-1746.2008.05559.x","article-title":"Confocal endomicroscopy in patients with ulcerative colitis","volume":"23","author":"Watanabe","year":"2008","journal-title":"J. Gastroenterol. Hepatol."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"1197","DOI":"10.1007\/s00535-011-0439-1","article-title":"Correlation between endocytoscopy and conventional histopathology in microstructural features of ulcerative colitis","volume":"46","author":"Bessho","year":"2011","journal-title":"J. Gastroenterol."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"2261","DOI":"10.1002\/ibd.22907","article-title":"Assessment of Crohn\u2019s disease activity by confocal laser endomicroscopy","volume":"18","author":"Neumann","year":"2012","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"1391","DOI":"10.1038\/ajg.2009.664","article-title":"Classification of inflammation activity in ulcerative colitis by confocal laser endomicroscopy","volume":"105","author":"Li","year":"2010","journal-title":"Am. J. Gastroenterol."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"E61","DOI":"10.1002\/ibd.23033","article-title":"Confocal laser endomicroscopy provides potential differentiation criteria between Crohn\u2019s disease and ulcerative colitis","volume":"19","author":"Hundorfean","year":"2013","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1038\/35013140","article-title":"Wireless capsule endoscopy","volume":"405","author":"Iddan","year":"2000","journal-title":"Nature"},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"1785","DOI":"10.1053\/j.gastro.2011.01.055","article-title":"Epidemiology and natural history of inflammatory bowel diseases","volume":"140","author":"Cosnes","year":"2011","journal-title":"Gastroenterology"},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1055\/a-1973-3796","article-title":"Small-bowel capsule endoscopy and device-assisted enteroscopy for diagnosis and treatment of small-bowel disorders: European Society of Gastrointestinal Endoscopy (ESGE) Guideline\u2014Update 2022","volume":"55","author":"Pennazio","year":"2023","journal-title":"Endoscopy"},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1097\/00042737-200304000-00005","article-title":"Wireless capsule video endoscopy is a superior diagnostic tool in comparison to barium follow-through and computerized tomography in patients with suspected Crohn\u2019s disease","volume":"15","author":"Eliakim","year":"2003","journal-title":"Eur. J. Gastroenterol. Hepatol."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"477","DOI":"10.4253\/wjge.v8.i14.477","article-title":"Video capsule endoscopy in inflammatory bowel disease","volume":"8","author":"Collins","year":"2016","journal-title":"World J. Gastrointest. Endosc."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1016\/j.crohns.2010.12.004","article-title":"Small bowel capsule endoscopy vs conventional techniques in patients with symptoms highly compatible with Crohn\u2019s disease","volume":"5","author":"Petruzziello","year":"2011","journal-title":"J. Crohn\u2019s Colitis"},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"3299","DOI":"10.3748\/wjg.v16.i26.3299","article-title":"Wireless capsule endoscopy and proximal small bowel lesions in Crohn\u2019s disease","volume":"16","author":"Petruzziello","year":"2010","journal-title":"World J. Gastroenterol."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"2218","DOI":"10.1111\/j.1572-0241.2006.00761.x","article-title":"The risk of retention of the capsule endoscope in patients with known or suspected Crohn\u2019s disease","volume":"101","author":"Cheifetz","year":"2006","journal-title":"Am. J. Gastroenterol."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"618","DOI":"10.1055\/s-0029-1214790","article-title":"Role of small-bowel endoscopy in the management of patients with inflammatory bowel disease: An international OMED-ECCO consensus. World Organisation of Digestive Endoscopy (OMED) and the European Crohn\u2019s and Colitis Organisation (ECCO)","volume":"41","author":"Bourreille","year":"2009","journal-title":"Endoscopy"},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"975","DOI":"10.1016\/j.gie.2015.06.012","article-title":"Enteroscopy","volume":"82","author":"Chauhan","year":"2015","journal-title":"Gastrointest. Endosc."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1055\/s-2005-921188","article-title":"Double-balloon enteroscopy: Indications, diagnostic yield, and complications in a series of 275 patients with suspected small-bowel disease","volume":"38","author":"Heine","year":"2006","journal-title":"Endoscopy"},{"key":"ref_87","doi-asserted-by":"crossref","unstructured":"Huang, Z., Liu, X., Yang, F., Wang, G., Ge, N., Wang, S., Guo, J., and Sun, S. (2020). Diagnostic efficacy of double-balloon enteroscopy inpatients with suspected isolated small bowel Crohn\u2019s disease. BMC Gastroenterol., 20.","DOI":"10.1186\/s12876-020-01188-0"},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1093\/ecco-jcc\/jjab180","article-title":"ECCO-ESGAR Topical Review on Optimizing Reporting for Cross-Sectional Imaging in Inflammatory Bowel Disease","volume":"26","author":"Kucharzik","year":"2022","journal-title":"J. Crohn\u2019s Colitis"},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"556","DOI":"10.1016\/j.crohns.2013.02.020","article-title":"Imaging techniques for assessment of inflammatory bowel disease: Joint ECCO and ESGAR evidence-based consensus guidelines","volume":"7","author":"JPanes","year":"2013","journal-title":"J. Crohn\u2019s Colitis"},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"1172","DOI":"10.1053\/j.gastro.2017.11.274","article-title":"Society of Abdominal Radiology Crohn\u2019s Disease-Focused Panel. Consensus recommendations for evaluation, interpretation, and utilization of computed tomography and magnetic resonance enterography in patients with small bowel Crohn\u2019s disease","volume":"154","author":"Bruining","year":"2018","journal-title":"Gastroenterology"},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"1795","DOI":"10.1053\/j.gastro.2011.02.013","article-title":"New concepts in intestinal imaging for inflammatory bowel diseases","volume":"140","author":"Fletcher","year":"2011","journal-title":"Gastroenterology"},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1080\/00365520310008485","article-title":"Sonographic detection of longitudinal ulcers in Crohn disease","volume":"39","author":"Kunihiro","year":"2004","journal-title":"Scand. J. Gastroenterol."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1111\/apt.12201","article-title":"Diffusion-weighted magnetic resonance imaging for detecting and assessing ileal inflammation in Crohn\u2019s disease","volume":"37","author":"Buisson","year":"2013","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_94","doi-asserted-by":"crossref","unstructured":"Sasaki, T., Kunisaki, R., Kinoshita, H., Kimura, H., Kodera, T., Nozawa, A., Hanzawa, A., Shibata, N., Yonezawa, H., and Miyajima, E. (2014). Doppler ultrasound findings correlate with tissue vascularity and inflammation in surgical pathology specimens from patients with small intestinal Crohn\u2019s disease. BMC Res. Notes, 7.","DOI":"10.1186\/1756-0500-7-363"},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"548","DOI":"10.1016\/S2468-1253(18)30161-4","article-title":"Diagnostic accuracy of magnetic resonance enterography and small bowel ultrasound for the extent and activity of newly diagnosed and relapsed Crohn\u2019s disease (METRIC): A multicentre trial","volume":"3","author":"Taylor","year":"2018","journal-title":"Lancet Gastroenterol. Hepatol."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"97","DOI":"10.5009\/gnl220422","article-title":"Comparison of an Endoscopic Scoring System and the Simplified Magnetic Resonance Index of Activity in Patients with Small Bowel Crohn\u2019s Disease","volume":"18","author":"Na","year":"2024","journal-title":"Gut Liver"},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"1117","DOI":"10.1080\/17474124.2023.2274926","article-title":"Small bowel imaging in inflammatory bowel disease: Updates for 2023","volume":"17","author":"Maira","year":"2023","journal-title":"Expert. Rev. Gastroenterol. Hepatol."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"1119","DOI":"10.1080\/17434440.2023.2283166","article-title":"Recent advances in the use of ultrasound in Crohn\u2019s disease","volume":"20","author":"Barchi","year":"2023","journal-title":"Expert. Rev. Med. Devices"},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"1280","DOI":"10.1093\/ecco-jcc\/jjy093","article-title":"Comparative accuracy of bowel ultrasound versus Magnetic resonance enterography in combination with colonoscopy in assessing Crohn\u2019s disease and guiding clinical decision-making","volume":"12","author":"Allocca","year":"2018","journal-title":"J. Crohn\u2019s Colitis"},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"432","DOI":"10.1053\/j.gastro.2019.03.051","article-title":"Development and validation of a simplified magnetic resonance index of activity for Crohn\u2019s disease","volume":"157","author":"Rimola","year":"2019","journal-title":"Gastroenterology"},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"2313676","DOI":"10.1080\/07853890.2024.2313676","article-title":"The role of molecular imaging in detecting fibrosis in Crohn\u2019s disease","volume":"56","author":"Alyami","year":"2024","journal-title":"Ann. Med."},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1097\/MIB.0000000000000997","article-title":"Bowel Thickening in Crohn\u2019s Disease: Fibrosis or Inflammation? Diagnostic Ultrasound Imaging Tools","volume":"23","author":"Coelho","year":"2017","journal-title":"Inflamm. Bowel Dis."},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"792","DOI":"10.1148\/radiol.2015150566","article-title":"Evaluation of quantitative PET\/MR enterography biomarkers for discrimination of inflammatory strictures from fibrotic strictures in Crohn disease","volume":"278","author":"Catalano","year":"2015","journal-title":"Radiology"},{"key":"ref_104","doi-asserted-by":"crossref","unstructured":"Foti, P.V., Travali, M., Farina, R., Palmucci, S., Coronella, M., Spatola, C., Puzzo, L., Garro, R., Inserra, G., and Riguccio, G. (2021). Can conventional and diffusion-weighted mr enterography biomarkers differentiate inflammatory from fibrotic strictures in crohn\u2019s disease?. Medicina, 5.","DOI":"10.3390\/medicina57030265"},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1148\/radiol.2361040799","article-title":"Role of US in detection of Crohn disease: Meta-analysis","volume":"236","author":"Fraquelli","year":"2005","journal-title":"Radiology"},{"key":"ref_106","first-page":"jjaa146","article-title":"Prevalence and Duration of Gastrointestinal Symptoms before Diagnosis of Inflammatory Bowel Disease and Predictors of Timely Specialist Review: A Population-Based Study. POP-IBD study group","volume":"15","author":"Blackwell","year":"2020","journal-title":"Crohn\u2019s Colitis."},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1053\/j.gastro.2020.03.007","article-title":"Serum Biomarkers Identify Patients Who Will Develop Inflammatory Bowel Diseases up to 5 Years Before Diagnosis","volume":"159","author":"Torres","year":"2020","journal-title":"Gastroenterology"},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"101263","DOI":"10.1016\/j.xcrm.2023.101263","article-title":"Characterizing the pre-clinical phase of inflammatory bowel disease","volume":"4","author":"Vestergaard","year":"2023","journal-title":"Cell Rep. Med."},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"i976","DOI":"10.1093\/ecco-jcc\/jjad212.0618","article-title":"P488 Development and validation of a risk prediction tool for inflammatory bowel disease (IBD) diagnosis in patients presenting in primary care with abdominal symptoms, a UK based study","volume":"18","author":"Umar","year":"2024","journal-title":"J. Crohn\u2019s Colitis"},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1093\/ecco-jcc\/jjv067","article-title":"Development of red flags index for early referral of adults with symptoms and signs suggestive of Crohn\u2019s disease: An IOIBD initiative","volume":"9","author":"Danese","year":"2015","journal-title":"J. Crohn\u2019s Colitis"},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"1777","DOI":"10.1093\/ecco-jcc\/jjaa111","article-title":"Validation of the red flags index for early diagnosis of Crohn\u2019s disease: A prospective observational IG-IBD study among general practitioners","volume":"14","author":"Fiorino","year":"2020","journal-title":"J. Crohn\u2019s Colitis"},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1007\/s00508-019-1451-3","article-title":"Diagnostic delay in patients with inflammatory bowel disease in Austria","volume":"131","author":"Novacek","year":"2019","journal-title":"Wien. Klin. Wochenschr."},{"key":"ref_113","doi-asserted-by":"crossref","first-page":"1744","DOI":"10.1038\/ajg.2013.248","article-title":"Diagnostic delay in Crohn\u2019s disease is associated with a complicated disease course and increased operation rate","volume":"108","author":"Schoepfer","year":"2013","journal-title":"Am. J. Gastroenterol."},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"586","DOI":"10.1080\/00365521.2019.1604799","article-title":"Noninvasive testing in the management of children with suspected inflammatory bowel disease","volume":"54","author":"Dilillo","year":"2019","journal-title":"Scand. J. Gastroenterol."},{"key":"ref_115","doi-asserted-by":"crossref","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":"Maconi","year":"2018","journal-title":"Ultraschall Med. Eur. J. Ultrasound"}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/14\/14\/1530\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T15:17:29Z","timestamp":1760109449000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/14\/14\/1530"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,16]]},"references-count":115,"journal-issue":{"issue":"14","published-online":{"date-parts":[[2024,7]]}},"alternative-id":["diagnostics14141530"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics14141530","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7,16]]}}}