P1035 Use of intestinal ultrasound and other imaging tests in ulcerative colitis and Crohn’s disease: insights from a German physician survey

Abstract Background Imaging tests play a critical role in the management of ulcerative colitis (UC) and Crohn’s disease (CD), including diagnosis, assessment, monitoring, and complication management. This study in Germany assessed physicians’ use of imaging tests and reasons for intestinal ultrasound (IUS) use by practice setting and perceived importance of transmural healing. Methods 76 Gastroenterologists in Germany who have prescribed advanced therapy in at least one patient with moderate-to-severe UC or CD in the past 12 months completed a web-based survey (September–October 2025). Data on physician characteristics, long-term treatment goals, imaging test use, and reasons for IUS use were summarized overall and stratified by practice setting and physicians’ perceived importance of transmural healing. Results Among 76 physicians (mean [SD] age 52.9 [8.1] years; mean [SD] practice duration 21.8 [6.8] years), most reported using colonoscopy (98.7%) and IUS (84.2%) for UC, and colonoscopy (96.1%), esophagogastroduodenoscopy (90.8%), and IUS (89.5%) for CD (Figure 1A). For UC, the most common reasons for IUS use were monitoring disease activity (95.3%), monitoring treatment response (81.2%), and assessing disease severity (65.6%). For CD, main reasons were monitoring disease activity (91.2%), treatment response (86.8%), and excluding stenosis, fistula, or abscess (70.6%) (Figure 1B). Across practice settings, most physicians used colonoscopy (94.1–100.0% for both UC and CD) and IUS (64.7–85.0% for UC; 82.4–90.3% for CD), with higher IUS use in private practices and hospitals (Figure 1C, 1E). IUS for disease-activity monitoring was more common in private practices and hospitals than medical care centers (UC: 100.0% vs 81.8%; CD: 93.3–100.0% vs 71.4%) while surveillance after surgery was more frequent in non-university hospitals than other settings (UC: 56.2% vs 34.6–46.7%; CD: 75.0% vs 46.4–64.3%) (Figure 1D, 1F). Physicians who viewed transmural healing as a most important long-term goal more often reported any IUS use than those viewing it as important or less important (UC: 93.3% vs 82.0%; CD: 94.7% vs 87.7%) and were also more likely to use IUS for treatment-response monitoring in UC (85.7% vs 80.0%) or for diagnosis in CD (72.2% vs 52.0%) (Table 1). Conclusion IUS is one of the most common imaging tests used among German gastroenterologists treating moderate-to-severe UC and CD across all practice settings, with greater use among those prioritizing transmural healing as a long-term goal. Monitoring disease activity and treatment response were the most common reasons for IUS use overall and across all physician subgroups, underscoring its central role and broad utility in routine clinical management. Conflict of interest: Blumenstein, Irina: Consulting and/or speker fees: AbbVie, Alfasigma, Amgen, Biogen, CED Service GmbH, Falk, Ferring, Fraunhofer, Johnson&Johnson, Pharmacosmos, Pfizer, Sanofi, Takeda, Tillotts Research grants: Fraunhofer ITMP, Sanofi Lu, Xiaoxiao: Xiaoxiao Lu is a Johnson & Johnson employee and holds Johnson & Johnson stock. No other financial or non-financial interests relevant to this work are declared. Kleine-Voßbeck, Ursula: employee of JnJ Adsul, Shashi: Current employee of Johnson and Johnson Innovative Medicine Past Employee of Takeda Pharmaceutical. Zhang, Yichen: YZ is an employee of Johnson & Johnson and may hold stock or stock options. Imran, Meshal: Employee of Johnson & Johnson. Wang, Yan: I am an employee of Analysis Group, Inc., which received funding from Johnson & Johnson for participation in research. Wang, Aolin: AW is an employee of Analysis Group which received consulting fees from Janssen Global Services, LLC. for this research. Hecht, Rouven: Employee of Johnson and Johnson Innovative Medicine Scharfenberger, Lukas: Employee of Janssen Cilag GmbH, a pharmaceutical company of Johnson&Johnson Pohlan, Julian: Currently employed bei Johnson & Johnson Innovative Medicine Bravatà, Ivana: Johnson and Johnson employee Piscitelli, Darren: Full-time employee of Johnson & Johnson and own company stock/stock options. Mrs. Smith, Jessica: JS is an employee of Analysis Group which received consulting fees from Janssen Global Services, LLC. for this research. Zhu, Anyu: AZ is an employee of Analysis Group which received consulting fees from Janssen Global Services, LLC. for this research. Ott, Claudia: Lecture Fee and consulting Fee by Abbvie, Alfasigma, Amgen, Bristol-Myers Squibb, Falk Foundation, Johnson & Johnson, Lilly, MSD, Pfizer, Takeda