Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2009 Apr 7;15(13):1587-93.
doi: 10.3748/wjg.15.1587.

Endoscopic ultrasound elastography for evaluation of lymph nodes and pancreatic masses: a multicenter study

Marc Giovannini  1 , Botelberge Thomas, Bories Erwan, Pesenti Christian, Caillol Fabrice, Esterni Benjamin, Monges Geneviève, Arcidiacono Paolo, Deprez Pierre, Yeung Robert, Schimdt Walter, Schrader Hanz, Szymanski Carl, Dietrich Christoph, Eisendrath Pierre, Van Laethem Jean-Luc, Devière Jacques, Vilmann Peter, Saftoiu Andrian
Affiliations
Multicenter Study

Endoscopic ultrasound elastography for evaluation of lymph nodes and pancreatic masses: a multicenter study

Marc Giovannini et al. World J Gastroenterol. .

Abstract

Aim: To evaluate the ability of endoscopic ultrasound (EUS) elastography to distinguish benign from malignant pancreatic masses and lymph nodes.

Methods: A multicenter study was conducted and included 222 patients who underwent EUS examination with assessment of a pancreatic mass (n = 121) or lymph node (n = 101). The classification as benign or malignant, based on the real time elastography pattern, was compared with the classification based on the B-mode EUS images and with the final diagnosis obtained by EUS-guided fine needle aspiration (EUS-FNA) and/or by surgical pathology. An interobserver study was performed.

Results: The sensitivity and specificity of EUS elastography to differentiate benign from malignant pancreatic lesions are 92.3% and 80.0%, respectively, compared to 92.3% and 68.9%, respectively, for the conventional B-mode images. The sensitivity and specificity of EUS elastography to differentiate benign from malignant lymph nodes was 91.8% and 82.5%, respectively, compared to 78.6% and 50.0%, respectively, for the B-mode images. The kappa coefficient was 0.785 for the pancreatic masses and 0.657 for the lymph nodes.

Conclusion: EUS elastography is superior compared to conventional B-mode imaging and appears to be able to distinguish benign from malignant pancreatic masses and lymph nodes with a high sensitivity, specificity and accuracy. It might be reserved as a second line examination to help characterise pancreatic masses after negative EUS-FNA and might increase the yield of EUS-FNA for lymph nodes.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Elastographic image showing homogenous soft tissue corresponding to normal tissue.
Figure 2
Figure 2
Elastographic image. A: Heterogenous soft tissue corresponding to fibrosis (benign nodule in patient who had an acute pancreatitis 2 mo before); B: Heterogenous soft tissue corresponding to inflammatory tissue (benign lymph node).
Figure 3
Figure 3
Elastographic image showing mixed hard and soft tissue (“honeycombed pattern”) making the interpretation difficult.
Figure 4
Figure 4
Elastographic image showing mainly hard tissue with a small soft central area corresponding to a malignant hypervascularized lesion (pancreatic neuroendocrine tumor).
Figure 5
Figure 5
Elastographic image showing mainly hard tissue with areas of heterogenous soft tissue corresponding to an advanced malignant lesion with necrotic areas (pancreatic adenocarcinoma).
Figure 6
Figure 6
Elastography score.
Figure 7
Figure 7
Pancreatic masses: elastography score and final histology.
Figure 8
Figure 8
Lymph nodes: elastography score and final histology.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Bhutani MS, Hawes RH, Hoffman BJ. A comparison of the accuracy of echo features during endoscopic ultrasound (EUS) and EUS-guided fine-needle aspiration for diagnosis of malignant lymph node invasion. Gastrointest Endosc. 1997;45:474–479. - PubMed
    1. Tamerisa R, Irisawa A, Bhutani MS. Endoscopic ultrasound in the diagnosis, staging, and management of gastrointestinal and adjacent malignancies. Med Clin North Am. 2005;89:139–158, viii. - PubMed
    1. Vazquez-Sequeiros E, Levy MJ, Clain JE, Schwartz DA, Harewood GC, Salomao D, Wiersema MJ. Routine vs. selective EUS-guided FNA approach for preoperative nodal staging of esophageal carcinoma. Gastrointest Endosc. 2006;63:204–211. - PubMed
    1. Eloubeidi MA, Chen VK, Eltoum IA, Jhala D, Chhieng DC, Jhala N, Vickers SM, Wilcox CM. Endoscopic ultrasound-guided fine needle aspiration biopsy of patients with suspected pancreatic cancer: diagnostic accuracy and acute and 30-day complications. Am J Gastroenterol. 2003;98:2663–2668. - PubMed
    1. Lyshchik A, Higashi T, Asato R, Tanaka S, Ito J, Mai JJ, Pellot-Barakat C, Insana MF, Brill AB, Saga T, et al. Thyroid gland tumor diagnosis at US elastography. Radiology. 2005;237:202–211. - PubMed

Publication types