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.
Highlights
Endoscopic ultrasound (EUS) elastography is another technique that measures the stiffness of tissue and adds more diagnostic value to EUS
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
Pancreatic tumors are diagnosed through imaging techniques such as contrast-enhanced multi-slice computed tomography (CT), magnetic resonance imaging, or endoscopic ultrasonography (EUS)
Summary
Endoscopic ultrasound (EUS) elastography is another technique that measures the stiffness of tissue and adds more diagnostic value to EUS. Majority of pancreatic tumors arise from epithelial cells, with adenocarcinoma being the most prevalent (90%).[1] Other epithelial tumors include cystic tumors and intraductal papillary mucinous neoplasms. Almasri and Ali (NETs), mesenchymal tumors, and metastatic tumors.[2] Some non-neoplastic lesions can manifest as masses such as inflammatory pseudotumors.[3] Pancreatic tumors are diagnosed through imaging techniques such as contrast-enhanced multi-slice computed tomography (CT), magnetic resonance imaging, or endoscopic ultrasonography (EUS). Pancreatic mass types are difficult to distinguish from each other using imaging techniques only. The gold standard for the diagnosis is pathology, which can be obtained by CT-guided or EUS-guided biopsy, but both have limitations and risks.[4]
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