TY - JOUR
T1 - Endoscopic ultrasound elastography for evaluation of lymph nodes and pancreatic masses
T2 - A multicenter study
AU - Giovannini, Marc
AU - Thomas, Botelberge
AU - Erwan, Bories
AU - Christian, Pesenti
AU - Fabrice, Caillol
AU - Benjamin, Esterni
AU - Geneviève, Monges
AU - Paolo, Arcidiacono
AU - Pierre, Deprez
AU - Robert, Yeung
AU - Walter, Schimdt
AU - Hanz, Schrader
AU - Carl, Szymanski
AU - Christoph, Dietrich
AU - Pierre, Eisendrath
AU - Jean-Luc, Van Laethem
AU - Devière, Jacques
AU - Peter, Vilmann
AU - Andrian, Saftoiu
PY - 2009/4/7
Y1 - 2009/4/7
N2 - Aim: 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. Conclusion: 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.
AB - Aim: 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. Conclusion: 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.
KW - Elasticity coefficient
KW - Elastography
KW - Endoscopic ultrasound
KW - Lymph node
KW - Pancreatic mass
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U2 - 10.3748/wjg.15.1587
DO - 10.3748/wjg.15.1587
M3 - Article
C2 - 19340900
AN - SCOPUS:64549147029
VL - 15
SP - 1587
EP - 1593
JO - World Journal of Gastroenterology
JF - World Journal of Gastroenterology
SN - 1007-9327
IS - 13
ER -