title: Endoscopic ultrasound elastography: Current status and future perspectives.
abstract: Elastography is a new ultrasound modality that provides images and measurements related to tissue stiffness. Endoscopic ultrasound (EUS) has played an important role in the diagnosis and management of numerous abdominal and mediastinal diseases. Elastography by means of EUS examination can assess the elasticity of tumors in the proximity of the digestive tract that are hard to reach with conventional transcutaneous ultrasound probes, such as pancreatic masses and mediastinal or abdominal lymph nodes, thus improving the diagnostic yield of the procedure. Results from previous studies have promised benefits for EUS elastography in the differential diagnosis of lymph nodes, as well as for assessing masses with pancreatic or gastrointestinal (GI) tract locations. It is important to mention that EUS elastography is not considered a modality that can replace biopsy. However, it may be a useful adjunct, improving the accuracy of EUS-fine needle aspiration biopsy (EUS-FNAB) by selecting the most suspicious area to be targeted. Even more, it may be useful for guiding further clinical management when EUS-FNAB is negative or inconclusive. In the present paper we will discuss the current knowledge of EUS elastography, including the technical aspects, along with its applications in the differential diagnosis between benign and malignant solid pancreatic masses and lymph nodes, as well as its aid in the differentiation between normal pancreatic tissues and chronic pancreatitis. Moreover, the emergent indication and future perspectives are summarized, such as the benefit of EUS elastography in EUS-guided fine needle aspiration biopsy, and its uses for characterization of lesions in liver, biliary tract, adrenal glands and GI tract.
authors.affiliation: Xin-Wu Cui, Jian-Min Chang, Christoph F Dietrich, Sino-German Research Center of Ultrasound in Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China.
authors.forename: Xin-Wu
authors.initials: XW
authors.lastname: Cui
authors.affiliation: Xin-Wu Cui, Jian-Min Chang, Christoph F Dietrich, Sino-German Research Center of Ultrasound in Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China.
authors.forename: Jian-Min
authors.initials: JM
authors.lastname: Chang
authors.affiliation: Xin-Wu Cui, Jian-Min Chang, Christoph F Dietrich, Sino-German Research Center of Ultrasound in Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China.
authors.forename: Quan-Cheng
authors.initials: QC
authors.lastname: Kan
authors.affiliation: Xin-Wu Cui, Jian-Min Chang, Christoph F Dietrich, Sino-German Research Center of Ultrasound in Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China.
authors.forename: Liliana
authors.initials: L
authors.lastname: Chiorean
authors.affiliation: Xin-Wu Cui, Jian-Min Chang, Christoph F Dietrich, Sino-German Research Center of Ultrasound in Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China.
authors.forename: Andre
authors.initials: A
authors.lastname: Ignee
authors.affiliation: Xin-Wu Cui, Jian-Min Chang, Christoph F Dietrich, Sino-German Research Center of Ultrasound in Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China.
authors.forename: Christoph F
authors.initials: CF
authors.lastname: Dietrich
mesh_terms: D003937:Diagnosis, Differential; D004548:Elasticity; D054459:Elasticity Imaging Techniques / Q000379:methods*; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration; D019160:Endosonography; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging* / Q000473:pathology; D008207:Lymphatic Metastasis; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D050500:Pancreatitis, Chronic / Q000000981:diagnostic imaging* / Q000473:pathology; D011237:Predictive Value of Tests; D015203:Reproducibility of Results
keywords: Characterization; Elastography; Endoscopic ultrasound; Lymph nodes; Pancreas