title: Endoscopic ultrasound elastography for evaluation of lymph nodes and pancreatic masses: a multicenter study.
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Endoscopy Unit, Paoli-Calmettes Institute, Marseille, France. giovanninim@wanadoo.fr
authors.forename: Marc
authors.initials: M
authors.lastname: Giovannini
authors.forename: Botelberge
authors.initials: B
authors.lastname: Thomas
authors.forename: Bories
authors.initials: B
authors.lastname: Erwan
authors.forename: Pesenti
authors.initials: P
authors.lastname: Christian
authors.forename: Caillol
authors.initials: C
authors.lastname: Fabrice
authors.forename: Esterni
authors.initials: E
authors.lastname: Benjamin
authors.forename: Monges
authors.initials: M
authors.lastname: Geneviève
authors.forename: Arcidiacono
authors.initials: A
authors.lastname: Paolo
authors.forename: Deprez
authors.initials: D
authors.lastname: Pierre
authors.forename: Yeung
authors.initials: Y
authors.lastname: Robert
authors.forename: Schimdt
authors.initials: S
authors.lastname: Walter
authors.forename: Schrader
authors.initials: S
authors.lastname: Hanz
authors.forename: Szymanski
authors.initials: S
authors.lastname: Carl
authors.forename: Dietrich
authors.initials: D
authors.lastname: Christoph
authors.forename: Eisendrath
authors.initials: E
authors.lastname: Pierre
authors.forename: Van Laethem
authors.initials: VL
authors.lastname: Jean-Luc
authors.forename: Devière
authors.initials: D
authors.lastname: Jacques
authors.forename: Vilmann
authors.initials: V
authors.lastname: Peter
authors.forename: Saftoiu
authors.initials: S
authors.lastname: Andrian