PDF | https://doi.org/10.46613/congastro2023-123
This work is licensed under CC BY 4.0
Robles C1, Del Valle R1, Egas M1, Puga M1, Baquerizo J1, Cunto D1, Arevalo M1, Alcivar J1, Alvarado H1, Pitanga H1
1Instituto Ecuatoriano de Enfermedades Digestivas (IECED), Guayaquil, Ecuador
Background: Endoscopic ultrasound (EUS)-guided shear wave elastography (EUS-SW) measures tissue elasticity by shear waves inside the organ through acoustic radiation force impulse. Its accuracy has not been assessed for chronic pancreatitis (CP) and solid pancreatic neoplasms (PN).
Aim: To estimate the diagnostic accuracy of EUS-SW for CP and solid PN.
Methods: Cases with a recently confirmed diagnosis of CP or PN who underwent EUS-SW were included. Cases with subepithelial lesion comprised the control group (CG). An expert endoscopist performed ten measurements of EUS-SW elasticity (SWE) and dispersion (SWD). SWE and SWD variation were based on quotient among interquartile range (IQR) and median. In cases with <30% variation, the association of SWE and SWD was estimated with study groups, baseline and EUS data through ANOVA. SWE and SWD cut-off values were calculated with Youden’s index.
Results: 88 cases: 37 CG, 14 CP, 37 PN, median age of 62.5 (IQR 53-70), 47.7% female. Median SR was lower in CG (3.6; IQR 2.9-4.3) and CP (3.9; IQR 3.6 – 4.7) but significantly higher in PN (7.6; IQR 5.3-11.1; p<.001). Median SWE and SWD were 10.5 kPa (7.3-16.6) and 1.9 [m/s]/kHz (1.6-2.4), with a <30% variation in 27 (30.7%) and 57 (64.8%), respectively. Study groups (CG/CP/PN) and diabetes were associated with a higher SWE and SWD (p<.05). Predicted SWE were significantly different among PN vs CG (-13.1; -24.4 to -1.7; p=.0242) (figure 1). An SWE ≥17.4 diagnosed PN with sensitivity, specificity, positive and negative predictive values of 75%, 91%, 60% and 95%; while an SWD ≥2.31 predicted PN with a diagnostic accuracy of 54%, 70%, 35%, 84%, respectively.
Conclusion: EUS-SW constitutes an objectively valuable measuring tool for CP and PN diagnostic workups. Larger multicentric trials are needed to confirm these findings, especially for CP.
