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. 2022 Mar 29;12(4):841.
doi: 10.3390/diagnostics12040841.

Evaluation of Ultrasound-Based Point Shear Wave Elastography for Differential Diagnosis of Pancreatic Diseases

Bozhidar Hristov  1   2 , Vladimir Andonov  1   2 , Daniel Doykov  1   2 , Silvia Tsvetkova  3 , Katya Doykova  3   4 , Mladen Doykov  5   6
Affiliations

Evaluation of Ultrasound-Based Point Shear Wave Elastography for Differential Diagnosis of Pancreatic Diseases

Bozhidar Hristov et al. Diagnostics (Basel). .

Abstract

Introduction: A variety of imaging techniques exists for the diagnosis of pancreatic disorders. None of the broadly applied diagnostic methods utilizes elasticity as an indicator of tissue damage. A well-known fact is that both chronic pancreatitis (CP) and pancreatic ductal adenocarcinoma (PDA) are associated with the development of prominent fibrosis (increased tissue stiffness).

Purpose: To prospectively assess the accuracy of point shear wave elastography (pSWE) in differentiating between benign and malignant pancreatic diseases, establish a cut-off value for the diagnosis of PDA, and evaluate the influence of certain variables on the obtained results.

Materials and methods: The present study included 78 patients who were admitted at the Department of Gastroenterology at the university hospital "Kaspela" between December 2017 and August 2021 for diagnosis and/or treatment of pancreatic disorders. Based on the clinical criteria, diagnostic imaging, and histological findings, patients were divided into the CP and PDA group. The ultrasound based pSWE technique was applied and shear wave velocity (SWV) was measured. The depth of region of interest (ROI) and successful measurement rate were also recorded.

Results: The mean ± SD SWV values established through pSWE were 1.75 ± 0.34 m/s and 2.93 ± 0.91 m/s for the CP and PDA, respectively. With a cut-off value of 2.09 m/s, we calculated the sensitivity (Se), specificity (Sp), and accuracy for differentiating between CP and PDA of 89.47%, 91.20%, and 88.60%, respectively. Of the examined variables, BMI and depth of ROI in the CP group and sex in the PDA group showed a statistically significant influence on the obtained results.

Conclusions: pSWE may be utilized as a differential diagnostic modality in patients with suspected CP or PDA.

Keywords: elastography; pSWE; pancreatic carcinoma; pancreatitis.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Association between depth of ROI and SWV in CP patients. *—significant association (p < 0.05); **—significant association (p < 0.01); rs—Spearman rank-order correlation (negative values re-flect inverse correlation).
Figure 2
Figure 2
Association between BMI and SWV in CP patients.
Figure 3
Figure 3
SWV values in correlation with obstructive jaundice.
Figure 4
Figure 4
Performance of pSWE for differentiating between CP and PDA.
See this image and copyright information in PMC

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