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Comparative Study
. 2025 Jun;57(6):1280-1287.
doi: 10.1016/j.dld.2025.03.013. Epub 2025 Apr 16.

Diagnosis and staging of chronic pancreatitis-Diagnostic accuracy and agreement between endoscopic ultrasound and transabdominal ultrasound shear wave elastography

Carlo Felix Maria Jung  1 , Cecilia Binda  2 , Elisa Liverani  2 , Elton Dajti  3 , Carmela Abbatiello  4 , Ludovica Cristofaro  3 , Luigina Vanessa Alemanni  2 , Alessandro Sartini  2 , Barbara Perini  5 , Paolo Giuffrida  2 , Chiara Coluccio  2 , Giulia Gibiino  2 , Stefano Fabbri  2 , Carla Serra  6 , Carlo Fabbri  2
Affiliations
Comparative Study

Diagnosis and staging of chronic pancreatitis-Diagnostic accuracy and agreement between endoscopic ultrasound and transabdominal ultrasound shear wave elastography

Carlo Felix Maria Jung et al. Dig Liver Dis. 2025 Jun.

Abstract

Background: Diagnosis of chronic pancreatitis (CP) is invasive and depending on endoscopic ultrasound (EUS) evaluation using Rosemont Criteria (RC). Non invasive ultrasound (US) based tests are necessary to detect CP.

Aim: We compared transabdominal 2D Shear Wave Elastography (SWE) of the pancreas and the Gemelli Ultrasound Chronic Pancreatitis Score to EUS/RC for the diagnosis of chronic pancreatitis.

Methods: We conducted a single center prospective case-control study. EUS with RC defined cohorts with (n = 51) and without CP (n = 51). Patients underwent US evaluation of the pancreas using 2D SWE and USCP.

Results: Median SWE values were different between groups (no CP 1.45m/s; IQR 1.34-1.60 and with CP 1.72m/s; IQR 1.63-1.96; p < 0.0001) and different between RC subgroups (RC indeterminate for CP 1.67m/s, IQR 1.52-1.72 vs. RC suggestive 1.72m/s, IQR 1.62-1.97 vs. RC consistent with CP 1.90 m/s, IQR 1.72-2.12 m/s; p < 0.0001). Median USCP was different between groups. 2D SWE correlated with USCP (p < 0.0001) and RC (p < 0.0001). We defined a cut off SWE value of <1.42m/s to rule out CP (Sensitivity 96 %; NPV 92 %) and a SWE cut off >1.87m/s to diagnose CP (Specifity 96 %;PPV 90 %).

Conclusion: Pancreatic US evaluation with 2D SWE is a widely applicable and unexpensive tool for the diagnosis of CP. Larger studies are needed to confirm these results.

Keywords: Chronic pancreatitis; Rosemont score; Shear wave elastography; Transabdominal ultrasound.

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Conflict of interest statement

Declaration of competing interest The article reports on the accuracy of transabdominal ultrasound based 2D Shear wave elastography for the detection of chronic pancreatitis or its early stages, compared to the standard of care in this field, endoscopic ultrasound. Our study shows how significantly transabdominal 2D SWE correlates with Rosemont criteria, especially in patients with early chronic pancreatitis, a finding which could lead to further and closer follow up in this special group. Additionally, we were able to confirm correlations between 2D SWE values and a new B Mode ultrasound pancreatic evaluation score (USCP Gemelli Score). These two ultrasound based methods together could play a decisive role in the evaluation of structural changes of the pancreatic gland. We hope you will find our work of interest to your readers and acceptable for publication in your journal. All authors state no conflict of interest. The manuscript has not been published previously and is not under consideration for publication elsewhere. The manuscript is approved by all authors. In case of acceptance of the manuscript the copyright is transferred to Digestive and Liver Disease.

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