Endoscopic Ultrasound Elastography for Evaluation of Lymph Nodes and Pancreatic Masses: a Multicenter Study

Overview

Journal World J Gastroenterol

Publisher Baishideng Publishing Group

Specialty Gastroenterology

Date 2009 Apr 3

PMID 19340900

Citations 108

Authors

Marc Giovannini

Botelberge Thomas

Bories Erwan

Pesenti Christian

Caillol Fabrice

Esterni Benjamin

Monges Genevieve

Arcidiacono Paolo

Deprez Pierre

Yeung Robert

Schimdt Walter

Schrader Hanz

Szymanski Carl

Dietrich Christoph

Eisendrath Pierre

Van Laethem Jean-Luc

Deviere Jacques

Vilmann Peter

Saftoiu Andrian

Affiliations

Soon will be listed here.

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.

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