Feasibility of tissue elastography using transcutaneous ultrasonography for the diagnosis of pancreatic diseases.
OBJECTIVE
We investigated the feasibility of using real-time tissue elastography (EG) with transcutaneous ultrasonography (EG-US) for pancreatic diseases.


METHODS
A preliminary study (phase I) and a prospective (phase II) study were conducted. Phase I: subjects were 10 volunteers, 5 with cancer, 2 with endocrine tumor, 5 with chronic pancreatitis, 14 with intraductal papillary-mucinous neoplasm. To determine the characteristic EG images (diagnostic criteria for phase II), B-mode images were compared with EG images and histopathologic findings. Phase II: 53 consecutive patients were enrolled. The visualization rate by EG-US in lesions visualized by B mode was assessed, and the correct diagnosis rate by B mode alone (B diagnosis) or in combination with EG-US was evaluated.


RESULTS
Phase I: normal parenchyma was a homogeneous color. In cancer, EG-US showed a markedly hard area with soft spots inside. Endocrine tumor was uniform and soft comparable to parenchyma. Chronic pancreatitis showed a mixture of various colors. Phase II: we identified 77.4% (41/53) of the lesions and observed 60.0% (15/25) of the cancers, 100% (3/3) of the endocrine tumor, 92.0% (23/25) of the cases of chronic pancreatitis cases on EG-US. The B-diagnosis rates ranged from about 70% to 80%. The diagnosis rates of the combination were more than 90% of lesions of each type.


CONCLUSIONS
The EG-US is feasible in the diagnosis of pancreatic diseases.
Uchida
Hiroki
H
Department of Gastroenterology, Nagoya University Graduate School of Medicine, Nagoya City, Japan.
Hirooka
Yoshiki
Y
Itoh
Akihiro
A
Kawashima
Hiroki
H
Hara
Kazuo
K
Nonogaki
Koji
K
Kasugai
Toshifumi
T
Ohno
Eizaburo
E
Ohmiya
Naoki
N
Niwa
Yasumasa
Y
Katano
Yoshiaki
Y
Ishigami
Masatoshi
M
Goto
Hidemi
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004548:Elasticity; D054459:Elasticity Imaging Techniques / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D050500:Pancreatitis, Chronic / Q000000981:diagnostic imaging* / Q000473:pathology; D010865:Pilot Projects; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012189:Retrospective Studies; D018615:Ultrasonography, Doppler, Color