1887
Volume 2021, Issue 2
  • ISSN: 0253-8253
  • EISSN: 2227-0426

Abstract

Introduction: Endoscopic ultrasound (EUS) elastography is another technique that measures the stiffness of tissue and adds more diagnostic value to EUS.

Objective: This study aimed to assess the ability of qualitative and quantitative EUS elastography in differentiating malignant from benign solid pancreatic masses.

Methods: This 2-year cross-sectional study enrolled 80 patients with solid pancreatic masses in the department of endoscopy in Alassad University Hospital who underwent conventional and elastography-assisted EUS and then followed for pathology through EUS-guided or CT-guided biopsy or surgery.

Results: Qualitative elastography using a 5-point scoring system was able to recognize malignant pathology (obtained by EUS-guided biopsy, CT-guided biopsy, or surgery) with a sensitivity, specificity, and accuracy rates of 100%, 28.6%, and 81.3%, respectively. A quantitative method using hue histogram had a sensitivity of 71.2%–86.4% and specificity of 71.4%–81% with the best accuracy for histogram mean ratio (area under the curve, 0.867).

Conclusion: EUS elastography is a simple and good alternative method in differentiating malignant from benign pancreatic solid masses.

Loading

Article metrics loading...

/content/journals/10.5339/qmj.2021.40
2021-09-07
2024-11-08
Loading full text...

Full text loading...

/deliver/fulltext/qmj/2021/2/qmj.2021.40.html?itemId=/content/journals/10.5339/qmj.2021.40&mimeType=html&fmt=ahah

References

  1. Feldmann G, Beaty R, Hruban RH, Maitra A, . Molecular genetics of pancreatic intraepithelial neoplasia. J Hepato-Bil Pancreat Surg.2007;14:224–32.
    [Google Scholar]
  2. Jun SY, Hong SM, . Nonductal pancreatic cancers. Surg Pathol Clin.2016;9:581–93.
    [Google Scholar]
  3. Lalwani N, Mannelli L, Ganeshan DM, Shanbhogue AK, Dighe MK, Tiwari HA, et al, . Uncommon pancreatic tumors and pseudotumors. Abdom Imaging.2015;40:167–80.
    [Google Scholar]
  4. McGuigan A, Kelly P, Turkington RC, Jones C, Coleman HG, McCain RS, . Pancreatic cancer: a review of clinical diagnosis, epidemiology, treatment and outcomes. World J Gastroenterol.2018;24:4846–61.
    [Google Scholar]
  5. Iglesias-Garcia J, Larino-Noia J, Abdulkader I,Forteza J, Dominguez-Munoz JE. EUS elastography for the characterization of solid pancreatic masses. Gastrointest Endosc.2009;70:1101–8.
    [Google Scholar]
  6. Giovannini M, Thomas B, Erwan B, Christian P, Fabrice C, Benjamin E, et al, . Endoscopic ultrasound elastography for evaluation of lymph nodes and pancreatic masses: a multicenter study. World J Gastroenterol.2009;15:1587–93.
    [Google Scholar]
  7. Sa˘ftoiu A, Vilmann P, Gorunescu F, Gheonea DI, Gorunescu M, Ciurea T, et al. Neural network analysis of dynamic sequences of EUS elastography used for the differential diagnosis of chronic pancreatitis and pancreatic cancer. Gastrointest Endosc.2008;68:1086–94.
    [Google Scholar]
  8. Ferreira T, Rasband WS. ImageJ User Guide - IJ 1.46r. imagej.nih.gov/ij/docs/guide, 2010–2012.
    [Google Scholar]
  9. Yousaf MN, Chaudhary FS, Ehsan A, Suarez AL, Muniraj T, Jamidar P, et al, . Endoscopic ultrasound (EUS) and the management of pancreatic cancer. BMJ Open Gastroenterol. 2020;7.
    [Google Scholar]
  10. Giovannini M, Hookey LC, Bories E, Pesenti C, Monges G, Delpero JR, . Endoscopic ultrasound elastography: the first step towards virtual biopsy? Preliminary results in 49 patients. Endoscopy.2006;38:344–8.
    [Google Scholar]
  11. Hocke M, Ignee A, Dietrich CF, . Advanced endosonographic diagnostic tools for discrimination of focal chronic pancreatitis and pancreatic carcinoma–elastography, contrast enhanced high mechanical index (CEHMI) and low mechanical index (CELMI) endosonography in direct comparison. Z Gastroenterol.2012;50:199–203.
    [Google Scholar]
  12. Iglesias-Garcia J, Larino-Noia J, Abdulkader I, Forteza J, Dominguez-Munoz JE. Quantitative endoscopic ultrasound elastography: an accurate method for the differentiation of solid pancreatic masses. Gastroenterology.2010;139:1172–80.
    [Google Scholar]
  13. Itokawa F, Itoi T, Sofuni A, Kurihara T, Tsuchiya T, Ishii K, et al, . EUS elastography combined with the strain ratio of tissue elasticity for diagnosis of solid pancreatic masses. J Gastroenterol.2011;46:843–53.
    [Google Scholar]
  14. Iordache S, Costache MI, Popescu CF, Streba CT, Cazacu S, Sa˘ftoiu A. Clinical impact of EUS elastography followed by contrast-enhanced EUS in patients with focal pancreatic masses and negative EUS-guided FNA. Med Ultrason.2016;18:18–24.
    [Google Scholar]
  15. Lariño-Noia J, Iglesias-Garcia J, Abdulkader I, Dominguez-Munoz E. Tu1662 quantifying endoscopic ultrasound (EUS)-guided elastography for the differential diagnosis of solid pancreatic masses: hue-histogram or strain ratio? Gastrointest Endosc. 2015;81.
    [Google Scholar]
  16. Opacˇic′ D, Rustemovic′ N, Kalauz M, Markoš P, Ostojic′ Z, Majerovic′ M, et al. Endoscopic ultrasound elastography strain histograms in the evaluation of patients with pancreatic masses. World J Gastroenterol.2015;21:4014–9.
    [Google Scholar]
  17. Sa˘ftoiu A, Iordache SA, Gheonea DI, Popescu C, Malos¸ A, Gorunescu F, et al. Combined contrast-enhanced power Doppler and real-time sonoelastography performed during EUS, used in the differential diagnosis of focal pancreatic masses (with videos). Gastrointest Endosc.2010;72:739–47.
    [Google Scholar]
  18. Sa˘ftoiu A, Vilmann P, Gorunescu F, Janssen J, Hocke M, Larsen M, et al. European EUS Elastography Multicentric Study Group. Accuracy of endoscopic ultrasound elastography used for differential diagnosis of focal pancreatic masses: a multicenter study. Endoscopy.2011;43:596–603.
    [Google Scholar]
/content/journals/10.5339/qmj.2021.40
Loading
/content/journals/10.5339/qmj.2021.40
Loading

Data & Media loading...

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error