Clin Endosc.  2013 Mar;46(2):172-177. 10.5946/ce.2013.46.2.172.

Endoscopic Ultrasound Elastography for the Pancreas in Korea: A Preliminary Single Center Study

Affiliations
  • 1Institute for Digestive Research, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, Korea. ydcho@schmc.ac.kr
  • 2Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea.

Abstract

BACKGROUND/AIMS
Endoscopic ultrasound elastography (EUS-EG) has been widely used for the evaluation of pancreatic cancer in the Western world. To date, there is very little experience with EUS-EG in Korea. We described the results of comparison between normal pancreas and pancreatic cancer in Korea.
METHODS
The present study was performed at a tertiary hospital on 35 subjects comprising 20 with normal pancreas (control group) and 15 with pancreatic cancer (disease group). We compared the EUS-EG performance of the two groups.
RESULTS
The pancreas in the control group showed a mean elasticity value of 0.53% (95% confidence interval [CI], 0.45 to 0.61). The elasticity value was higher than that previously reported from Western country (0.47%; 95% CI, 0.38 to 0.57). In the disease group, the mean elasticity value of pancreatic lesions was 0.02% (95% CI, 0.01 to 0.02). The mean elasticity value of the disease group was significantly lower than that of the control group (p<0.0001).
CONCLUSIONS
EUS-EG could be a highly sensitive diagnostic modality for pancreatic cancer in Korea with little EUS-EG experience. We also provided the reference range of elasticity value of normal pancreas, which might be valuable in the interpretation of pancreatic elasticity data for Korean adults.

Keyword

Elasticity imaging techniques; Endosonography; Pancreas

MeSH Terms

Adult
Elasticity
Elasticity Imaging Techniques
Endosonography
Humans
Korea
Pancreas
Pancreatic Neoplasms
Reference Values
Tertiary Care Centers
Western World

Figure

  • Fig. 1 Elasticity measurements of the pancreas in the control group. (A) Normal-appearing pancreas on B-mode. (B) Green color with homogeneous distribution throughout the pancreatic parenchyma. (C) Two areas (A and B) were selected, among the regions of interest, for quantitative analysis.

  • Fig. 2 Elasticity measurements of pancreatic lesions in the disease group. (A) Dual views show the elastography mode (left panel) and B-mode (right panel). The area with green/heterogeneous pattern is representative of peripancreatic tissue, while the lesion with blue/heterogeneous pattern is representative of pancreatic cancer. (B) Area A was selected for quantitative analysis among the regions of interest.

  • Fig. 3 Comparison of mean elasticity values of the pancreas and pancreatic lesions between the control group and the disease group. The mean elasticity value of the disease group was significantly lower than that of the control group (p<0.001).


Cited by  3 articles

Elastography of the Pancreas, Current View
Christoph F. Dietrich, Michael Hocke
Clin Endosc. 2019;52(6):533-540.    doi: 10.5946/ce.2018.156.

Diagnostic Efficacy of Endoscopic Ultrasound Elastography in Differentiating Solid Pancreatic Lesions: A Single-Center Experience
Ahmed Youssef Altonbary, Hazem Hakim, Ahmed Mohamed El-Shamy
Clin Endosc. 2019;52(4):360-364.    doi: 10.5946/ce.2018.160.

Endoscopic Ultrasound Elastography for Pancreatic Cancer Diagnosis: A Step Forward?
Woo Jin Lee
Clin Endosc. 2013;46(2):116-117.    doi: 10.5946/ce.2013.46.2.116.


Reference

1. Itoh A, Ueno E, Tohno E, et al. Breast disease: clinical application of US elastography for diagnosis. Radiology. 2006; 239:341–350. PMID: 16484352.
Article
2. Cochlin DL, Ganatra RH, Griffiths DF. Elastography in the detection of prostatic cancer. Clin Radiol. 2002; 57:1014–1020. PMID: 12409113.
Article
3. Krouskop TA, Wheeler TM, Kallel F, Garra BS, Hall T. Elastic moduli of breast and prostate tissues under compression. Ultrason Imaging. 1998; 20:260–274. PMID: 10197347.
Article
4. 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; 70:1101–1108. PMID: 19647248.
Article
5. Giovannini M, Thomas B, Erwan B, et al. Endoscopic ultrasound elastography for evaluation of lymph nodes and pancreatic masses: a multicenter study. World J Gastroenterol. 2009; 15:1587–1593. PMID: 19340900.
Article
6. Hirche TO, Ignee A, Barreiros AP, et al. Indications and limitations of endoscopic ultrasound elastography for evaluation of focal pancreatic lesions. Endoscopy. 2008; 40:910–917. PMID: 19009483.
Article
7. Janssen J, Schlörer E, Greiner L. EUS elastography of the pancreas: feasibility and pattern description of the normal pancreas, chronic pancreatitis, and focal pancreatic lesions. Gastrointest Endosc. 2007; 65:971–978. PMID: 17531630.
Article
8. Saftoiu A, Vilman P. Endoscopic ultrasound elastography: a new imaging technique for the visualization of tissue elasticity distribution. J Gastrointestin Liver Dis. 2006; 15:161–165. PMID: 16802011.
9. 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; 38:344–348. PMID: 16680632.
Article
10. 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; 139:1172–1180. PMID: 20600020.
Article
11. Frey H. Realtime elastography. A new ultrasound procedure for the reconstruction of tissue elasticity. Radiologe. 2003; 43:850–855. PMID: 14605701.
12. Lee TH, Cha SW, Cho YD. EUS elastography: advances in diagnostic EUS of the pancreas. Korean J Radiol. 2012; 13(Suppl 1):S12–S16. PMID: 22563282.
Article
13. Ophir J, Céspedes I, Ponnekanti H, Yazdi Y, Li X. Elastography: a quantitative method for imaging the elasticity of biological tissues. Ultrason Imaging. 1991; 13:111–134. PMID: 1858217.
Article
14. Jacobson BC. Pressed for an answer: has elastography finally come to EUS? Gastrointest Endosc. 2007; 66:301–303. PMID: 17643703.
Article
15. Rosch T, Lorenz R, Braig C, Dancygier H, Classen M. Endoscopic ultrasound in small pancreatic tumors. Z Gastroenterol. 1991; 29:110–115. PMID: 2058229.
16. Yasuda K, Mukai H, Fujimoto S, Nakajima M, Kawai K. The diagnosis of pancreatic cancer by endoscopic ultrasonography. Gastrointest Endosc. 1988; 34:1–8. PMID: 3280392.
Article
Full Text Links
  • CE
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr