ASGE Annual GI Advanced Practice Provider Course (Virtual) - Clinical Case-Based Learning (Day Two) | March 2024-The Role of Imaging in Managing Crohn’s Disease

Pdf Summary

This document discusses the role of imaging in managing Crohn's Disease (CD). It reviews the utility of different imaging modalities and explores their indications in CD management. The document also discusses the integration of advanced practice providers (APPs) in CD management.<br /><br />The small bowel is the most commonly affected area in CD, and the location of the disease can impact the therapy selected and the outcome of therapy. Imaging modalities such as small bowel follow through (SBFT), CT enterography (CTE), MR enterography (MRE), intestinal ultrasound (IUS), and capsule endoscopy (CE) are useful in diagnosing, assessing disease extent/activity, and monitoring response to therapy.<br /><br />SBFT is widely available but has limitations in evaluating inflammation. CTE and MRE have higher sensitivity in detecting active disease and extraintestinal manifestations compared to SBFT. MRE is superior to CTE in evaluating perianal complications. CE is valuable in situations where other imaging procedures are inconclusive. It has a higher diagnostic yield for CD compared to SBFT.<br /><br />The document emphasizes the importance of choosing the right imaging test for the right patient based on their specific needs. It highlights the benefits and drawbacks of each imaging modality.<br /><br />The role of APPs in CD management is also discussed. Trained non-physician readers can save time and improve diagnostic accuracy in CE investigations. APPs can aid in revenue generation, save physicians time, collaborate with physicians on diagnosis and treatment, perform bedside point-of-care testing, and complement endoscopy.<br /><br />The document concludes by summarizing the key points discussed, including the preferred imaging modalities for different scenarios and the emerging role of IUS in CD management. It highlights the integration of APPs as an important component of future CD care.

Asset Subtitle

Kimberly Kearns, MS, APN-BC

Keywords

Imaging in Crohn's Disease management

Small bowel follow through

CT enterography

MR enterography

Intestinal ultrasound

Capsule endoscopy

Role of advanced practice providers in CD management

Disease extent and activity assessment

Therapy response monitoring

Diagnostic yield for CD