Cai S, Lim C T, Tan Y Y, Tay Y X, Cheong E H T, Tan M T K
Radiography Department, Allied Health Division, Singapore General Hospital, Outram Road, Singapore 169608, Singapore.
Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore.
Radiography (Lond). 2025 Aug;31(5):103114. doi: 10.1016/j.radi.2025.103114. Epub 2025 Aug 5.
Magnetic resonance enterography (MRE) used widely for inflammatory bowel disease (IBD) activity assessment is costly and resource intensive. This study evaluates the impact of a transdisciplinary collaboration in intestinal ultrasound (IUS), focusing on its cost savings and environmental sustainability.
We conducted a retrospective analysis of IUS performed at a tertiary referral hospital in Singapore between October 2023 and June 2024. Patients with Crohn's disease (CD) underwent IUS as part of their clinical evaluation. The multidisciplinary team included four radiographers and two radiologists, all trained in IUS, and five gastroenterologists. Data collected included patient demographics, diagnosis, imaging history, and institutional costs for procedures. Estimates for energy consumption and carbon emissions were derived from published literature.
26 patients (16 males, 10 females) with CD underwent 34 IUS examinations. IUS findings led to MRE avoidance in 27 cases (n = 27/34; 79.4 %) and colonoscopy in 20 cases (n = 20/34; 58.8 %), eliminating the need for 540 ml of gadolinium-based contrast and 36,450 ml of barium sulphate suspension. Compared to MRE pathway, there was an estimated cost saving of US$29,619, reduction in energy consumption by approximately 304.83 kWh, equivalent to 458.19 kg of COe. Compared to endoscopy pathway, estimated cost saving was US$25,940 with 3181.0 kWh reduction in energy consumption, equivalent to 557.40 kg of COe.
IUS is a cost efficient and environmentally friendly alternative to MRE. Its addition to routine IBD care is a promising step towards high-quality, value-based decision-making while reducing the carbon footprint of radiological investigations.
The success of this initiative highlights the importance of transdisciplinary collaboration. Involving trained radiographers in IUS delivery can streamline imaging workflows, enhance access, reduce healthcare costs, and align clinical practice with sustainability goals.
广泛用于评估炎症性肠病（IBD）活动度的磁共振小肠造影（MRE）成本高昂且资源消耗大。本研究评估了跨学科协作开展肠道超声检查（IUS）的影响，重点关注其成本节约和环境可持续性。
我们对2023年10月至2024年6月在新加坡一家三级转诊医院进行的IUS检查进行了回顾性分析。克罗恩病（CD）患者接受IUS检查作为其临床评估的一部分。多学科团队包括四名均接受过IUS培训的放射技师和两名放射科医生，以及五名胃肠病学家。收集的数据包括患者人口统计学信息、诊断结果、影像检查史以及检查的机构成本。能源消耗和碳排放估计值来自已发表的文献。
26例（16例男性，10例女性）CD患者接受了34次IUS检查。IUS检查结果使27例（n = 27/34；79.4%）患者无需进行MRE检查，20例（n = 20/34；58.8%）患者无需进行结肠镜检查，从而无需使用540毫升钆基造影剂和36450毫升硫酸钡混悬液。与MRE检查流程相比，估计节省成本29619美元，能源消耗减少约304.83千瓦时，相当于减少458.19千克二氧化碳当量。与内镜检查流程相比，估计节省成本25940美元，能源消耗减少3181.0千瓦时，相当于减少557.40千克二氧化碳当量。
IUS是一种经济高效且环保的MRE替代方法。将其纳入IBD常规诊疗是朝着高质量、基于价值的决策迈出的有前景的一步，同时可减少放射学检查的碳足迹。
该举措的成功凸显了跨学科协作的重要性。让经过培训的放射技师参与IUS检查可简化影像检查流程，增加可及性，降低医疗成本，并使临床实践符合可持续发展目标。
