Intestinal ultrasound for Crohn's disease: A single-centre experience in cost and carbon emissions reduction through transdisciplinary collaboration.

INTRODUCTION

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.

METHODS

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.

RESULTS

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.

CONCLUSION

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.

IMPLICATIONS FOR PRACTICE

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.