Abstract Background Accurate assessment of inflammation within the intestinal wall is crucial in managing patients with Inflammatory Bowel Disease (IBD), a condition with rising incidence and prevalence worldwide. Ultrasound offers an effective, non-invasive diagnostic option to diagnose and monitor the disease. However, traditional ultrasound is highly user-dependent and requires considerable experience to accurately determine the degree of inflammation. As an extension, Quantitative Ultrasound (QUS), the analysis of raw ultrasound data consisting of unprocessed acoustic signals, contains both frequency and phase information, enabling spectroscopy. We hypothesize that these signals allow a precise estimation of inflammation within the intestinal wall. Methods The study was conducted at the Sonography Departments of University Clinic Dresden and Charité- Universitätsmedizin Berlin, where patients attended bowel examinations. In addition to the Limberg-Score acquired with a Highend-Ultrasound-Systems, raw data were obtained using a handheld ultrasound device (Clarius L15). For spectroscopy analysis, time-gain compensation was first reversed from the radio frequency data, followed by frequency analysis using short-time fast Fourier transformation. Results We included 35 patients (22 male, 13 female) aged 19 to 85 years. They were either diagnosed with Crohn’s disease (24) or ulcerative colitis (11). Our results indicate a positive correlation between the Limberg score (0–4) and peak frequency in MHz, as determined through the raw ultrasound data spectroscopy. Pairwise comparisons applying analysis of variance (ANOVA) testing, followed by a t-test with Benjamini-Hochberg correction as post hoc, revealed statistically significant differences between Limberg scores 0 and 2 (p ≤ 0.05), 0 and 3 (p ≤ 0.01) and scores 0 and 4 (p ≤ 0.05). The comparison between groups 0 and 1 demonstrated a trend but did not reach statistical significance (p=0.058). Conclusion Our findings indicate that higher Limberg scores are associated with increased center frequency, with statistically significant differences evident at advanced inflammation levels. This exploratory study demonstrates, for the first time, the capability of QUS to detect changes in intestinal tissues, offering an innovative approach for objectively monitoring inflammatory bowel disease. However, potential confounders such as attenuation in varying imaging depths and mixed causality of the inflammation need to be considered. A reevaluation after including larger sample sizes is required to reinforce the study’s findings and further explore the potential of QUS in the context of IBD.
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