title: Diagnostic potential of endoscopic ultrasonography-elastography for gastric submucosal tumors: A pilot study.
abstract: OBJECTIVE
  Qualitative diagnosis for gastric submucosal tumors (SMT) is not easy. Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) in combination with EUS-elastography (EUS-EG) is reported useful for qualitatively diagnosing pancreatic tissues. We prospectively studied whether EUS-EG could be useful in qualitative diagnosis of gastric SMT.
  
  
  METHODS
  We prospectively registered 25 consecutive patients with gastric SMT diagnosed by esophagogastroduodenoscopy and carried out qualitative evaluations using EUS-EG (May 2013 to March 2015) followed by histopathological diagnosis using EUS-FNA or endoscopic mucosal cutting biopsy. Elastic scores of gastric SMT were compared to the cytological diagnosis.
  
  
  RESULTS
  Of 25 patients, 22 had a confirmed cytological diagnosis. Regarding the Giovannini elastic score, of three patients with aberrant pancreas, one was score 1 and two were score 2; of eight patients with leiomyoma, seven were score 2 and one was score 3. Both of two patients with schwannoma were score 4. Of nine patients with gastrointestinal stromal tumor, six were score 4 and three were score 5. Gastrointestinal stromal tumor (GIST) is harder than other types of gastric SMT, and our study's findings suggested the usefulness of EUS-EG, which can also assess tumor hardness of gastric SMT.
  
  
  CONCLUSIONS
  EUS-EG might be helpful for the differential diagnosis of gastric SMT, especially to differentiate GIST from other SMT.
authors.affiliation: Departments of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan.
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Tsuji
authors.affiliation: Departments of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan.
authors.forename: Chika
authors.initials: C
authors.lastname: Kusano
authors.affiliation: Departments of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan.
authors.forename: Takuji
authors.initials: T
authors.lastname: Gotoda
authors.affiliation: Departments of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan.
authors.forename: Fumihide
authors.initials: F
authors.lastname: Itokawa
authors.affiliation: Departments of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan.
authors.forename: Masakatsu
authors.initials: M
authors.lastname: Fukuzawa
authors.affiliation: Departments of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Sofuni
authors.affiliation: Anatomic Pathology, Tokyo Medical University, Tokyo, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Matsubayashi
authors.affiliation: Anatomic Pathology, Tokyo Medical University, Tokyo, Japan.
authors.forename: Toshitaka
authors.initials: T
authors.lastname: Nagao
authors.affiliation: Departments of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan.
authors.forename: Takao
authors.initials: T
authors.lastname: Itoi
authors.affiliation: Departments of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan.
authors.forename: Fuminori
authors.initials: F
authors.lastname: Moriyasu
mesh_terms: D003937:Diagnosis, Differential; D054459:Elasticity Imaging Techniques / Q000379:methods*; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration / Q000379:methods*; D019160:Endosonography / Q000379:methods*; D005500:Follow-Up Studies; D046152:Gastrointestinal Stromal Tumors / Q000175:diagnosis*; D005773:Gastroscopy / Q000379:methods*; D006801:Humans; D010865:Pilot Projects; D012189:Retrospective Studies; D013270:Stomach / Q000000981:diagnostic imaging*; D013274:Stomach Neoplasms / Q000175:diagnosis*
keywords: elastography; endoscopic diagnosis; endoscopic ultrasonography; endoscopic ultrasonography-guided fine-needle aspiration (EUS-FNA); gastric submucosal tumor