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Published in: Journal of Gastroenterology 4/2012

01-04-2012 | Original Article—Liver, Pancreas, and Biliary Tract

Acoustic radiation force impulse elastography for noninvasive assessment of chronic pancreatitis

Authors: Yoko Yashima, Naoki Sasahira, Hiroyuki Isayama, Hirofumi Kogure, Hitoshi Ikeda, Kenji Hirano, Suguru Mizuno, Hiroshi Yagioka, Kazumichi Kawakubo, Takashi Sasaki, Yousuke Nakai, Minoru Tada, Haruhiko Yoshida, Masao Omata, Kazuhiko Koike

Published in: Journal of Gastroenterology | Issue 4/2012

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Abstract

Background

Endoscopic ultrasonography or real-time elastography has been applied for the diagnosis of chronic pancreatitis. Acoustic radiation force impulse (ARFI) imaging is another tissue strain imaging technology, and recent technological advances have enabled quantification of the stiffness of some tissues by measuring the shear wave velocity (SWV) during routine B-mode ultrasonography.

Methods

ARFI elastography was performed in 52 healthy volunteers and 46 patients with chronic pancreatitis. SWV was measured in the head, body, and tail of the pancreas. The diagnostic performance was assessed using receiver-operating characteristic (ROC) curves.

Results

SWV in patients with chronic pancreatitis was significantly higher than that in healthy volunteers in each part of the pancreas, although the measurement was difficult in the tail of the pancreas. The area under the ROC curve was 0.78 in the body of the pancreas, with an optimal cut-off value of 1.40 m/s, and the sensitivity, specificity, positive predictive value, and negative predictive value were 75, 72, 69, and 78%, respectively. In the patients with chronic pancreatitis, alcoholic etiology and decreased body mass index (BMI) were associated with high SWV.

Conclusions

ARFI elastography of the pancreas showed high elasticity in chronic pancreatitis compared to findings in the normal pancreas. This modality is feasible to use for the diagnosis of chronic pancreatitis.
Literature
2.
go back to reference Kahl S, Glasbrenner B, Leodolter A, Pross M, Schulz HU, Malfertheiner P. EUS in the diagnosis of early chronic pancreatitis: a prospective follow-up study. Gastrointest Endosc. 2002;55:507–11.PubMedCrossRef Kahl S, Glasbrenner B, Leodolter A, Pross M, Schulz HU, Malfertheiner P. EUS in the diagnosis of early chronic pancreatitis: a prospective follow-up study. Gastrointest Endosc. 2002;55:507–11.PubMedCrossRef
3.
go back to reference Catalano MF, Sahai A, Levy M, Romagnuolo J, Wiersema M, Brugge W, et al. EUS-based criteria for the diagnosis of chronic pancreatitis: the Rosemont classification. Gastrointest Endosc. 2009;69:1251–61.PubMedCrossRef Catalano MF, Sahai A, Levy M, Romagnuolo J, Wiersema M, Brugge W, et al. EUS-based criteria for the diagnosis of chronic pancreatitis: the Rosemont classification. Gastrointest Endosc. 2009;69:1251–61.PubMedCrossRef
4.
go back to reference Wallace MB, Hawes RH, Durkalski V, Chak A, Mallery S, Catalano MF, et al. The reliability of EUS for the diagnosis of chronic pancreatitis: interobserver agreement among experienced endosonographers. Gastrointest Endosc. 2001;53:294–9.PubMed Wallace MB, Hawes RH, Durkalski V, Chak A, Mallery S, Catalano MF, et al. The reliability of EUS for the diagnosis of chronic pancreatitis: interobserver agreement among experienced endosonographers. Gastrointest Endosc. 2001;53:294–9.PubMed
5.
go back to reference Stevens T, Lopez R, Adler DG, Al-Haddad MA, Conway J, Dewitt JM, et al. Multicenter comparison of the interobserver agreement of standard EUS scoring and Rosemont classification scoring for diagnosis of chronic pancreatitis. Gastrointest Endosc. 2010;71:519–26. Stevens T, Lopez R, Adler DG, Al-Haddad MA, Conway J, Dewitt JM, et al. Multicenter comparison of the interobserver agreement of standard EUS scoring and Rosemont classification scoring for diagnosis of chronic pancreatitis. Gastrointest Endosc. 2010;71:519–26.
6.
go back to reference Cespedes I, Ophir J, Ponnekanti H, Maklad N. Elastography: elasticity imaging using ultrasound with application to muscle and breast in vivo. Ultrason Imaging. 1993;15:73–88.PubMedCrossRef Cespedes I, Ophir J, Ponnekanti H, Maklad N. Elastography: elasticity imaging using ultrasound with application to muscle and breast in vivo. Ultrason Imaging. 1993;15:73–88.PubMedCrossRef
7.
go back to reference Konig K, Scheipers U, Pesavento A, Lorenz A, Ermert H, Senge T. Initial experiences with real-time elastography guided biopsies of the prostate. J Urol. 2005;174:115–7.PubMedCrossRef Konig K, Scheipers U, Pesavento A, Lorenz A, Ermert H, Senge T. Initial experiences with real-time elastography guided biopsies of the prostate. J Urol. 2005;174:115–7.PubMedCrossRef
8.
go back to reference Uchida H, Hirooka Y, Itoh A, Kawashima H, Hara K, Nonogaki K, et al. Feasibility of tissue elastography using transcutaneous ultrasonography for the diagnosis of pancreatic diseases. Pancreas. 2009;38:17–22.PubMedCrossRef Uchida H, Hirooka Y, Itoh A, Kawashima H, Hara K, Nonogaki K, et al. Feasibility of tissue elastography using transcutaneous ultrasonography for the diagnosis of pancreatic diseases. Pancreas. 2009;38:17–22.PubMedCrossRef
9.
go back to reference Janssen J, Dietrich CF, Will U, Greiner L. Endosonographic elastography in the diagnosis of mediastinal lymph nodes. Endoscopy. 2007;39:952–7.PubMedCrossRef Janssen J, Dietrich CF, Will U, Greiner L. Endosonographic elastography in the diagnosis of mediastinal lymph nodes. Endoscopy. 2007;39:952–7.PubMedCrossRef
10.
go back to reference Sandrin L, Fourquet B, Hasquenoph JM, Yon S, Fournier C, Mal F, et al. Transient elastography: a new noninvasive method for assessment of hepatic fibrosis. Ultrasound Med Biol. 2003;29:1705–13.PubMedCrossRef Sandrin L, Fourquet B, Hasquenoph JM, Yon S, Fournier C, Mal F, et al. Transient elastography: a new noninvasive method for assessment of hepatic fibrosis. Ultrasound Med Biol. 2003;29:1705–13.PubMedCrossRef
11.
go back to reference Castera L, Vergniol J, Foucher J, Le Bail B, Chanteloup E, Haaser M, et al. Prospective comparison of transient elastography, Fibrotest, APRI, and liver biopsy for the assessment of fibrosis in chronic hepatitis C. Gastroenterology. 2005;128:343–50.PubMedCrossRef Castera L, Vergniol J, Foucher J, Le Bail B, Chanteloup E, Haaser M, et al. Prospective comparison of transient elastography, Fibrotest, APRI, and liver biopsy for the assessment of fibrosis in chronic hepatitis C. Gastroenterology. 2005;128:343–50.PubMedCrossRef
12.
go back to reference Nightingale KR, Palmeri ML, Nightingale RW, Trahey GE. On the feasibility of remote palpation using acoustic radiation force. J Acoust Soc Am. 2001;110:625–34.PubMedCrossRef Nightingale KR, Palmeri ML, Nightingale RW, Trahey GE. On the feasibility of remote palpation using acoustic radiation force. J Acoust Soc Am. 2001;110:625–34.PubMedCrossRef
13.
go back to reference Nightingale K, Soo MS, Nightingale R, Trahey G. Acoustic radiation force impulse imaging: in vivo demonstration of clinical feasibility. Ultrasound Med Biol. 2002;28:227–35.PubMedCrossRef Nightingale K, Soo MS, Nightingale R, Trahey G. Acoustic radiation force impulse imaging: in vivo demonstration of clinical feasibility. Ultrasound Med Biol. 2002;28:227–35.PubMedCrossRef
14.
go back to reference Friedrich-Rust M, Wunder K, Kriener S, Sotoudeh F, Richter S, Bojunga J, et al. Liver fibrosis in viral hepatitis: noninvasive assessment with acoustic radiation force impulse imaging versus transient elastography. Radiology. 2009;252:595–604.PubMedCrossRef Friedrich-Rust M, Wunder K, Kriener S, Sotoudeh F, Richter S, Bojunga J, et al. Liver fibrosis in viral hepatitis: noninvasive assessment with acoustic radiation force impulse imaging versus transient elastography. Radiology. 2009;252:595–604.PubMedCrossRef
15.
go back to reference Sarvazyan AP, Rudenko OV, Swanson SD, Fowlkes JB, Emelianov SY. Shear wave elasticity imaging: a new ultrasonic technology of medical diagnostics. Ultrasound Med Biol. 1998;24:1419–35.PubMedCrossRef Sarvazyan AP, Rudenko OV, Swanson SD, Fowlkes JB, Emelianov SY. Shear wave elasticity imaging: a new ultrasonic technology of medical diagnostics. Ultrasound Med Biol. 1998;24:1419–35.PubMedCrossRef
16.
go back to reference Nightingale K, McAleavey S, Trahey G. Shear-wave generation using acoustic radiation force: in vivo and ex vivo results. Ultrasound Med Biol. 2003;29:1715–23.PubMedCrossRef Nightingale K, McAleavey S, Trahey G. Shear-wave generation using acoustic radiation force: in vivo and ex vivo results. Ultrasound Med Biol. 2003;29:1715–23.PubMedCrossRef
18.
go back to reference Fahey BJ, Nightingale KR, Nelson RC, Palmeri ML, Trahey GE. Acoustic radiation force impulse imaging of the abdomen: demonstration of feasibility and utility. Ultrasound Med Biol. 2005;31:1185–98.PubMedCrossRef Fahey BJ, Nightingale KR, Nelson RC, Palmeri ML, Trahey GE. Acoustic radiation force impulse imaging of the abdomen: demonstration of feasibility and utility. Ultrasound Med Biol. 2005;31:1185–98.PubMedCrossRef
19.
go back to reference Braganza JM, Hunt LP, Warwick F. Relationship between pancreatic exocrine function and ductal morphology in chronic pancreatitis. Gastroenterology. 1982;82:1341–7.PubMed Braganza JM, Hunt LP, Warwick F. Relationship between pancreatic exocrine function and ductal morphology in chronic pancreatitis. Gastroenterology. 1982;82:1341–7.PubMed
20.
go back to reference Ammann RW, Buehler H, Muench R, Freiburghaus AW, Siegenthaler W. Differences in the natural history of idiopathic (nonalcoholic) and alcoholic chronic pancreatitis. A comparative long-term study of 287 patients. Pancreas. 1987;2:368–77.PubMedCrossRef Ammann RW, Buehler H, Muench R, Freiburghaus AW, Siegenthaler W. Differences in the natural history of idiopathic (nonalcoholic) and alcoholic chronic pancreatitis. A comparative long-term study of 287 patients. Pancreas. 1987;2:368–77.PubMedCrossRef
21.
go back to reference Masuzaki R, Tateishi R, Yoshida H, Goto E, Sato T, Ohki T, et al. Prospective risk assessment for hepatocellular carcinoma development in patients with chronic hepatitis C by transient elastography. Hepatology. 2009;49:1954–61.PubMedCrossRef Masuzaki R, Tateishi R, Yoshida H, Goto E, Sato T, Ohki T, et al. Prospective risk assessment for hepatocellular carcinoma development in patients with chronic hepatitis C by transient elastography. Hepatology. 2009;49:1954–61.PubMedCrossRef
22.
go back to reference Foucher J, Chanteloup E, Vergniol J, Castera L, Le Bail B, Adhoute X, et al. Diagnosis of cirrhosis by transient elastography (FibroScan): a prospective study. Gut. 2006;55:403–8.PubMedCrossRef Foucher J, Chanteloup E, Vergniol J, Castera L, Le Bail B, Adhoute X, et al. Diagnosis of cirrhosis by transient elastography (FibroScan): a prospective study. Gut. 2006;55:403–8.PubMedCrossRef
23.
go back to reference Lowenfels AB, Maisonneuve P, Cavallini G, Ammann RW, Lankisch PG, Andersen JR, et al. Pancreatitis and the risk of pancreatic cancer. International Pancreatitis Study Group. N Engl J Med. 1993;328:1433–7.PubMedCrossRef Lowenfels AB, Maisonneuve P, Cavallini G, Ammann RW, Lankisch PG, Andersen JR, et al. Pancreatitis and the risk of pancreatic cancer. International Pancreatitis Study Group. N Engl J Med. 1993;328:1433–7.PubMedCrossRef
24.
go back to reference Malka D, Hammel P, Maire F, Rufat P, Madeira I, Pessione F, et al. Risk of pancreatic adenocarcinoma in chronic pancreatitis. Gut. 2002;51:849–52.PubMedCrossRef Malka D, Hammel P, Maire F, Rufat P, Madeira I, Pessione F, et al. Risk of pancreatic adenocarcinoma in chronic pancreatitis. Gut. 2002;51:849–52.PubMedCrossRef
25.
go back to reference Cremer M, Deviere J, Delhaye M, Baize M, Vandermeeren A. Stenting in severe chronic pancreatitis: results of medium-term follow-up in seventy-six patients. Endoscopy. 1991;23:171–6.PubMedCrossRef Cremer M, Deviere J, Delhaye M, Baize M, Vandermeeren A. Stenting in severe chronic pancreatitis: results of medium-term follow-up in seventy-six patients. Endoscopy. 1991;23:171–6.PubMedCrossRef
26.
go back to reference Delhaye M, Vandermeeren A, Baize M, Cremer M. Extracorporeal shock-wave lithotripsy of pancreatic calculi. Gastroenterology. 1992;102:610–20.PubMed Delhaye M, Vandermeeren A, Baize M, Cremer M. Extracorporeal shock-wave lithotripsy of pancreatic calculi. Gastroenterology. 1992;102:610–20.PubMed
27.
go back to reference Sasahira N, Tada M, Isayama H, Hirano K, Nakai Y, Yamamoto N, et al. Outcomes after clearance of pancreatic stones with or without pancreatic stenting. J Gastroenterol. 2007;42:63–9.PubMedCrossRef Sasahira N, Tada M, Isayama H, Hirano K, Nakai Y, Yamamoto N, et al. Outcomes after clearance of pancreatic stones with or without pancreatic stenting. J Gastroenterol. 2007;42:63–9.PubMedCrossRef
Metadata
Title
Acoustic radiation force impulse elastography for noninvasive assessment of chronic pancreatitis
Authors
Yoko Yashima
Naoki Sasahira
Hiroyuki Isayama
Hirofumi Kogure
Hitoshi Ikeda
Kenji Hirano
Suguru Mizuno
Hiroshi Yagioka
Kazumichi Kawakubo
Takashi Sasaki
Yousuke Nakai
Minoru Tada
Haruhiko Yoshida
Masao Omata
Kazuhiko Koike
Publication date
01-04-2012
Publisher
Springer Japan
Published in
Journal of Gastroenterology / Issue 4/2012
Print ISSN: 0944-1174
Electronic ISSN: 1435-5922
DOI
https://doi.org/10.1007/s00535-011-0491-x

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