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
Review
. 2017 Oct 16;9(10):506-513.
doi: 10.4253/wjge.v9.i10.506.

Endoscopic ultrasound elastography for solid pancreatic lesions

Tanyaporn Chantarojanasiri  1 , Pradermchai Kongkam  2
Affiliations
Review

Endoscopic ultrasound elastography for solid pancreatic lesions

Tanyaporn Chantarojanasiri et al. World J Gastrointest Endosc. .

Abstract

Elastography is one of technologies assisting diagnosis of solid pancreatic lesions (SPL). This technology has been previously used for measuring the stiffness of various organs based on a principle of "harder the lesions, higher chance for malignancy". Two elastography techniques; strain and shear wave elastography, are available. For endoscopic ultrasound (EUS), only the former is existing. To interpret results of EUS elastography for SPL, 3 methods are used: (1) pattern recognition; (2) strain ratio; and (3) strain histogram. Based on results of existing studies, these 3 techniques provide high sensitivity but low to moderate specificity and accuracy rate. This review will summarize all available information in order to update current situation of using elastography for an evaluation of SPLs to readers.

Keywords: Chronic pancreatitis; Elastography; Endoscopic ultrasound; Pancreatic cancer; Solid pancreatic lesions.

PubMed Disclaimer

Conflict of interest statement

Conflict-of-interest statement: The authors revealed no conflict of interest in relation to this review.

Figures

Figure 1
Figure 1
The principle of strain elastography is illustrated by coil spring appearance. A: After applying pressure, more deformation is demonstrated in tissue with higher elasticity; B: The strain on each tissue depends on the tissue stiffness; C: Higher strain is seen in softer tissue after compression (Adapted from Ophir[2]).
Figure 2
Figure 2
The principle of endoscopic ultrasound elastography for solid pancreatic lesions. A: Pancreatic carcinoma has more stiffness than normal pancreas; B: The strain elastography measured the degree of displacement after applying manual pressure or vascular pulsation; C: The degree of displacement is represented as colors: Green is the average stiffness, blue is stiffer tissue, and red is softer tissue.
Figure 3
Figure 3
Classification of elastography findings proposed by Giovannini[4].
Figure 4
Figure 4
Histogram analysis using MATLABver 1.6.7. A and B: The color image of the elastography is converted into the gray scale (value) of 256 tones ranging from 0 to 255:0 represents the blue area (hard) and 255 represents the red area (soft); C: The distribution of the gray scale is presented as a histogram from which the parameters are calculated.
Figure 5
Figure 5
Endoscopic ultrasound elastography of pancreatic adenocarcinoma. The color pattern showed predominant blue color pattern without distortion of surrounding area.
See this image and copyright information in PMC

References

    1. Ueno E, Tohno E, Soeda S, Asaoka Y, Itoh K, Bamber JC, Blaszçzyk M, Davey J, Mckinna JA. Dynamic tests in real-time breast echography. Ultrasound Med Biol. 1988;14 Suppl 1:53–57. - PubMed
    1. 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. - PubMed
    1. Shiina T, Nitta N, Ueno E, Bamber JC. Real time tissue elasticity imaging using the combined autocorrelation method. J Med Ultrason (2001) 2002;29:119–128. - PubMed
    1. 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. - PubMed
    1. Hirooka Y, Kuwahara T, Irisawa A, Itokawa F, Uchida H, Sasahira N, Kawada N, Itoh Y, Shiina T. JSUM ultrasound elastography practice guidelines: pancreas. J Med Ultrason (2001) 2015;42:151–174. - PubMed

LinkOut - more resources