Endoscopic Ultrasound Elastography: Preliminary Results for Gastro-Intestinal Masses and Lymph Nodes

Abstract

Background and Aim: It is known that some diseases, such as cancer, lead to changes in the hardness of tissue. Endoscopic Ultrasound Elastography (EUE) is a new technique to assess the elasticity of tissue. It is expected to improve the ability for diagnosis. The aim of this study was to evaluate EUE to differentiate between benign and malignant gastro-intestinal masses and lymph nodes. Patients and Method: During a three month period, 10 patients underwent EUE examinations. Three patients underwent evaluation of esophageal cancer, two of gastric cancer, three of submucosal tumor, two of lymph nodes, which all cases were diagnosed histopahologically after examinations. Result: All cases could be drawn images of EUE, which can be classified into three patterns. Type1 is for entire green area, relatively soft tissue. Type2 is for green and a blue mosaic pattern. Type3 is for entire blue area, relatively hard tissue. In the esophageal cancer cases, a normal wall was drawn as type1 and a neoplasm part was drawn as type3. The malignant lymph node was drawn as type3, but the inflammatory lmph node the view of type2. In the stomach cancer cases, a neoplasm part was drawn as type2 or type3. In the submucosal tumor, GIST was shown as type3 and aberrant pancreas was shown as type1. The duodenum lymph-angioma case, which shown cystic lesion with conventional EUS, were drawn as type3, seems to be different from the solid tumor. No complication occurred with EUE examinations. Conclusion: EUE can provide important information and have a possibility to distinguish benign and malignant solid masses.