UChicago Medicine trains physicians on ‘game-changing’ intestinal ultrasound
March 8, 2023
A select group of gastroenterologists from around the world will gather at the University of Chicago Medicine March 16-18 for demonstrations and training on how to perform intestinal ultrasound (IUS). The groundbreaking procedure provides a fast, real-time, noninvasive look at what’s happening in the intestines for a variety of conditions, including ulcerative colitis and Crohn’s disease.
UChicago Medicine is the second hospital in the country to offer intestinal ultrasounds to its Inflammatory Bowel Disease (IBD) patients who would otherwise need colonoscopies or other tests and procedures to assess inflammation and monitor treatments.
Only a handful of doctors nationwide have been trained to perform and interpret IUS. Training was not available for American doctors until 2022, said gastroenterologist Noa Krugliak Cleveland, MD, director of UChicago Medicine’s Intestinal Ultrasound Program.
This is the first time a procedure can predict response to a treatment as early as the first week of treatment.
UChicago Medicine’s training course, in collaboration with the International Bowel Ultrasound Group, is made possible by a $1.7 million grant from the Leona M. and Harry B. Helmsley Charitable Trust.
Just 30 IBD physicians from a pool of 120 applicants were chosen to attend the three days of presentations, videos, and hands-on sessions with actual patients.
Krugliak Cleveland and David T. Rubin, MD, Chief of UChicago Medicine’s Section of Gastroenterology, Hepatology and Nutrition, joined their international colleagues and taught a previous session last September in New York. Another session is planned in March 2024 in Los Angeles.
“This technology is game-changing for our patients and for the field,” said Rubin, who is co-directing the Chicago course with Krugliak Cleveland.
IUS works similarly to a pregnancy ultrasound; gel is applied to the abdomen, then an ultrasound probe is used to see the bowel in real time. The procedure can be performed during a regular visit in the clinic room, allowing a doctor to instantly see if the bowel is inflamed or how a patient is responding to therapy.
“Prior to the availability of IUS, we relied on colonoscopy, CT scans, MRIs, blood or stool tests to assess for inflammation. These are invasive, expensive, inconvenient and time-consuming," Krugliak Cleveland said. "Now, I can perform IUS as I am seeing a patient in clinic. Together, we see the bowel and make treatment decisions during the visit without delays. This is also the first time a procedure can predict response to a treatment as early as the first week of treatment.”
IUS does not require the colonoscopy and the colonoscopy prep that's unpopular with patients. However, Kugliak Cleveland noted, colonoscopies are still needed for the screening and prevention of colorectal cancer.
More information on the event can be found here.
University of Chicago is a leading center here in the United States in disseminating intestinal ultrasound education across the US. And we're one of the few centers that offer this integrated intestinal ultrasound into IBD care.
We are very grateful to the Helmsley Charitable Trust who provided us with a three year grant to disseminate intestinal ultrasound in the United States through a series of workshops that are coordinated by the International Bowel Ultrasound Group.
I can see in your abdomen these little blood vessels.
So over the last two days, we held an intestinal ultrasound hands on workshop where we hosted 20 international experts in bowel ultrasound and 30 IBD experts from all over the country and some also from Canada. And trained them in intestinal ultrasound through both didactics and hands on training with live patients and simulators.
When you get to be a bit more skilled, it can be, as you know, posterior, so it can come behind the cecum.
And in order to train people in this technology, they have to come not just to a conference and listen to lectures, they also need to be able to do it. They have to be able to hold the probe in their hand, put it on a patient and know what they're looking at.
You see the contents, you see the wall layers.
Uh-huh.
Measure those wall layers.
Now, that's beautiful.
As you start to train other people then it kind of offloads the volume as they start to do it in their own clinic, and you start to build this out. So it's kind of evolved over time.
When you first start doing this, your colleagues may not know enough about it or be skeptical, and one of the things that Noah did was send out an email a couple of times to the rest of the IBD faculty and nurses to tell them that this was available and that it's here and then also to be available to them. And you, sort of, convert people as you do these and show them the value of it.
When you start putting a probe on a real patient, and you see their eyes light up and you can actually see what's happening in their body, it is absolutely unmatched. Our goal is to bring this to every patient who has Crohn's and colitis in the United States and frankly, in the world. And in order to do that, we have to teach it, we have to demonstrate, it we have to incorporate it in our clinical trials and in our clinical management strategies.
And then we have to make it available and accessible. Is this the type of training that will work with the practices we have with the volume of patients we see and with the hurdles and time constraints that exist in our practices that are different than some of our colleagues in other parts of the world? So we're actually trying to reinvent some of this in a way that will work for us with the ultimate goal that we want every patient with inflammatory bowel disease to have access to this as a proactive test.
Not one that you just do when someone's sick. I think it's absolutely going to change our field and we're very proud at the University of Chicago to be helping lead this effort and to do what we're doing.
David T. Rubin, MD
Dr. Rubin specializes in the treatment of digestive diseases. His expertise includes inflammatory bowel diseases (Crohn’s disease and ulcerative colitis) and high-risk cancer syndromes.
See Dr. Rubin's physician bio
Noa Krugliak Cleveland, MD
Dr. Krugliak Cleveland specializes in gastroenterology and serves as Director of the Intestinal Ultrasound Program at UChicago Medicine.
Learn more about Dr. Krugliak Cleveland
