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

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.

journal_name

World J Gastroenterol

authors

Giovannini M,Thomas B,Erwan B,Christian P,Fabrice C,Benjamin E,Geneviève M,Paolo A,Pierre D,Robert Y,Walter S,Hanz S,Carl S,Christoph D,Pierre E,Jean-Luc VL,Jacques D,Peter V,Andrian S

doi

10.3748/wjg.15.1587

subject

Has Abstract

pub_date

2009-04-07 00:00:00

pages

1587-93

issue

13

eissn

1007-9327

issn

2219-2840

journal_volume

15

pub_type

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