Learning curve in intestinal ultrasound: advancing from basic skills to advanced competencies–insights from the IUS IG-IBD Master program
Year: 2025
Type: article
Abstract: BACKGROUND: Intestinal ultrasound (IUS) is increasingly valuable in inflammatory bowel disease (IBD) management. OBJECTIVE: This study aimed to determine the learning curve for basic and advanced IUS parameters and establish the minimum number of examinations required for diagnostic proficiency. DESIGN: We conducted a prospective, multicenter study across eight Italian tertiary IBD centers. Eight gastroenterology trainees with extensive abdominal ultrasound experience but limited IUS exposure completed standardized training comprising theoretical education, 30 supervised examinations, and 99 independent assessments. Expert sonographers independently and blindly reassessed all independent examinations using identical protocols. Interobserver agreement was quantified using Cohen's kappa coefficients across 12 predefined categories, stratified into basic (bowel wall thickness, vascularity, stratification) and advanced (fistulas, collections, strictures) findings. RESULTS: Following initial training, trainees demonstrated substantial baseline competency. Basic parameters achieved consistently high performance throughout the study period (from κ = 0.792 to κ = 0.842), while advanced findings showed more pronounced learning curves, improving from κ = 0.728 to κ = 0.854. Small bowel dilation exhibited the steepest learning trajectory (κ = 0.674 to κ = 0.921, 36.6% improvement, P = .204). Sustained primary competence (κ ≥ 0.8) was achieved by 37.5-62.5% of trainees for basic parameters within 99 examinations, with bowel wall stratification proving most challenging (37.5% success rate). CONCLUSION: This study establishes the first comprehensive, parameter-specific learning thresholds for IUS competency in IBD. Our findings demonstrate that structured training enables basic IUS proficiency within 69-112 examinations for experienced ultrasonographers, while advanced skills require extended practice. These data represent an important step toward defining evidence-based benchmarks for IUS training, supporting the development of standardized international curricula and safe clinical implementation.
Source: Journal of Crohn s and Colitis
Authors: Cristina Bezzio, Luisa Bertin, Simone Saibeni, Davide Giuseppe Ribaldone, Federica Furfaro, Giovanni Maconi, Fulvia Terracciano, Elena Mazzotta, Emma Calabrese, Fabiana Castiglione, Ambrogio Orlando, Giuseppe Privitera, Sara Massironi, Francesca Zorzi, Lorena Pirola, Silvio Danese, Antonio Rispo, Flavio Caprioli, Mirella Fraquelli, Demis Pitoni, Arianna Dal Buono, Anna Testa, Massimo Claudio Fantini, Alessandro Armuzzi, Mariangela Allocca, Collaborators, Nicola Imperatore, Marta Vernero, Simona Ricciolino, Manuela Marzo, Alessia Guarino, Valentino Calvez, Alessia Todeschini, Elena Bartolini, Emanuele Orlando, Caterina Zoratti, Gaia Riguccio
Institutions: Humanitas University, IRCCS Humanitas Research Hospital, University of Padua, Aziende Socio Sanitaria Territoriale Rhodense, University of Turin, Vita-Salute San Raffaele University, IRCCS Ospedale San Raffaele, University of Milan, ASST Fatebenefratelli Sacco, Casa Sollievo della Sofferenza, IRCCS Azienda Ospedliero-Universitaria di Bologna Policlinico di Sant'Orsola, University of Rome Tor Vergata, Federico II University Hospital, University of Naples Federico II, Ospedale Vincenzo Cervello, Azienda Ospedaliera San Gerardo, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Cagliari, Azienda Ospedaliero-Universitaria Cagliari
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,790
OpenAlex ID: W7117117927