SHEAR-WAVE ELASTOGRAPHY VERSUS STRAIN ELASTOGRAPHY WITH HISTOGRAM ANALYSIS IN SOLID PANCREATIC LESIONS: A PILOT STUDY

Aims Strain elastography endoscopic ultrasound (SE-EUS) has been proved as a valuable supplement to endoscopic ultrasound (EUS) in assessing solid pancreatic lesions, with sensitivity of 98% and specificity of 63%. However, the value of newly available shear wave EUS elastography (SWM-EUS) has been disappointing in one retrospective study. Aim: to assess the diagnostic value of SE-EUS and EUS-SWM in solid pancreatic lesions.

Methods Our prospective study was started in August 2021 in one tertiary medical center and we recruited patients with solid pancreatic masses>2 cm in diameter at CT scan for EUS assessment first with SE-EUS and strain histogram (SH) (3 measurements), followed by SWM-EUS (3 measurements with VsN>20). Patients with inconclusive pathology results were excluded. The final diagnosis was based on surgery or EUS tissue acquisition results.

Results Thirty-six patients with solid pancreatic lesions were evaluated. The final diagnosis was 20 pancreatic adenocarcinoma, 4 neuroendocrine pancreatic tumors (NETs), 6 chronic pancreatitis and 6 other types of lesions. The mean value of SH and SW for pancreatic adenocarcinoma were 20.24 and 23.41kPa, for chronic pancreatitis were 18.13 and 9.98kPa, for NETs were 38.83 and 20.59kPa, respectively, but the difference between the two elastography methods (T-test, P=0,06) was not statistically significant.

Conclusions In this prospective study we found no significant difference between SE-EUS and EUS-SMW. Further research is needed on this topic in order to face the challenges in standardize the EUS-SMW procedure in pancreatic lesions, mainly related to the deep location of the lesions and respiratory movements.

Publication History

Article published online:
14 April 2022