Skip to main content
Top
Published in: Journal of Medical Ultrasonics 3/2020

01-07-2020 | Ultrasound | Special Feature: Review Article

Present status of ultrasound elastography for the diagnosis of pancreatic tumors: review of the literature

Authors: Takamichi Kuwahara, Kazuo Hara, Nobumasa Mizuno, Shin Haba, Nozomi Okuno

Published in: Journal of Medical Ultrasonics | Issue 3/2020

Login to get access

Abstract

Ultrasound elastography is a relatively new diagnostic technique for measuring tissue elasticity (hardness). This review describes the types and evaluation methods of elastographies used in diagnosing pancreatic tumors. It also evaluates the diagnostic ability of transabdominal (US) or endoscopic ultrasonography (EUS) elastography for pancreatic tumors, based on findings from a search of published articles. Twenty articles (2096 cases) were selected from the databases. The types of elastography used for the diagnosis of pancreatic tumors were strain elastography and shear wave elastography. The evaluation methods of elastography and their diagnostic abilities (sensitivity and specificity) were 0.78 (95% confidence interval 0.65–0.87) and 0.82 (0.63–0.94) for color pattern diagnosis (US), 0.82 (0.77–0.86) and 0.70 (0.64–0.76) for color pattern diagnosis (EUS), 0.94 (0.90–0.97) and 0.87 (0.81–0.92) for strain ratio (EUS), 0.92 (0.90–0.94) and 0.79 (0.75–0.82) for histogram analysis (EUS), and 0.90 (0.82–0.95) and 0.82 (0.57–0.72) for shear wave elastography. In conclusion, there are many types of elastographies and evaluation methods, and the diagnostic ability for pancreatic tumors is high for each evaluation method.
Literature
1.
go back to reference Hu DM, Gong TT, Zhu Q. Endoscopic ultrasound elastography for differential diagnosis of pancreatic masses: a meta-analysis. Dig Dis Sci. 2013;58:1125–31.CrossRef Hu DM, Gong TT, Zhu Q. Endoscopic ultrasound elastography for differential diagnosis of pancreatic masses: a meta-analysis. Dig Dis Sci. 2013;58:1125–31.CrossRef
2.
go back to reference Shiina T. JSUM ultrasound elastography practice guidelines: basics and terminology. J Med Ultrason. 2013;40:309–23.CrossRef Shiina T. JSUM ultrasound elastography practice guidelines: basics and terminology. J Med Ultrason. 2013;40:309–23.CrossRef
3.
go back to reference Nakashima K, Shiina T, Sakurai M, et al. JSUM ultrasound elastography practice guidelines: breast. J Med Ultrason. 2013;40:359–91.CrossRef Nakashima K, Shiina T, Sakurai M, et al. JSUM ultrasound elastography practice guidelines: breast. J Med Ultrason. 2013;40:359–91.CrossRef
4.
go back to reference Lyshchik A, Higashi T, Asato R, et al. Thyroid gland tumor diagnosis at US elastography. Radiology. 2005;237:202–11.CrossRef Lyshchik A, Higashi T, Asato R, et al. Thyroid gland tumor diagnosis at US elastography. Radiology. 2005;237:202–11.CrossRef
5.
go back to reference Tsutsumi M, Miyagawa T, Matsumura T, et al. The impact of real-time tissue elasticity imaging (elastography) on the detection of prostate cancer: clinicopathological analysis. Int J Clin Oncol. 2007;12:250–5.CrossRef Tsutsumi M, Miyagawa T, Matsumura T, et al. The impact of real-time tissue elasticity imaging (elastography) on the detection of prostate cancer: clinicopathological analysis. Int J Clin Oncol. 2007;12:250–5.CrossRef
6.
go back to reference Kudo M, Shiina T, Moriyasu F, et al. JSUM ultrasound elastography practice guidelines: liver. J Med Ultrasonics. 2013;40:325–57.CrossRef Kudo M, Shiina T, Moriyasu F, et al. JSUM ultrasound elastography practice guidelines: liver. J Med Ultrasonics. 2013;40:325–57.CrossRef
7.
go back to reference Hirooka Y, Kuwahara T, Irisawa A, et al. JSUM ultrasound elastography practice guidelines: pancreas. J Med Ultrason. 2015;42:151–74.CrossRef Hirooka Y, Kuwahara T, Irisawa A, et al. JSUM ultrasound elastography practice guidelines: pancreas. J Med Ultrason. 2015;42:151–74.CrossRef
8.
go back to reference Kuwahara T, Hirooka Y, Kawashima H, et al. Quantitative diagnosis of chronic pancreatitis using EUS-elastography. J Gastroenterol. 2017;52:868–74.CrossRef Kuwahara T, Hirooka Y, Kawashima H, et al. Quantitative diagnosis of chronic pancreatitis using EUS-elastography. J Gastroenterol. 2017;52:868–74.CrossRef
9.
go back to reference Kuwahara T, Hirooka Y, Kawashima H, et al. Usefulness of shear wave elastography as a quantitative diagnosis of chronic pancreatitis. J Gastroenterol Hepatol. 2018;33:756–61.CrossRef Kuwahara T, Hirooka Y, Kawashima H, et al. Usefulness of shear wave elastography as a quantitative diagnosis of chronic pancreatitis. J Gastroenterol Hepatol. 2018;33:756–61.CrossRef
10.
go back to reference Kuwahara T, Hirooka Y, Kawashima H, et al. Quantitative evaluation of pancreatic tumor fibrosis using shear wave elastography. Pancreatology. 2016;16:1063–8.CrossRef Kuwahara T, Hirooka Y, Kawashima H, et al. Quantitative evaluation of pancreatic tumor fibrosis using shear wave elastography. Pancreatology. 2016;16:1063–8.CrossRef
11.
go back to reference Hashizume K, Hirooka Y, Kawashima H, et al. The propagation display method improves the reproducibility of pancreatic shear wave elastography. Ultrasound Med Biol. 2019;45:2242–7.CrossRef Hashizume K, Hirooka Y, Kawashima H, et al. The propagation display method improves the reproducibility of pancreatic shear wave elastography. Ultrasound Med Biol. 2019;45:2242–7.CrossRef
12.
go back to reference Ohno E, Hirooka Y, Kawashima H, et al. Feasibility and usefulness of endoscopic ultrasonography-guided shear-wave measurement for assessment of autoimmune pancreatitis activity: a prospective exploratory study. J Med Ultrason. 2001;2019(46):425–33. Ohno E, Hirooka Y, Kawashima H, et al. Feasibility and usefulness of endoscopic ultrasonography-guided shear-wave measurement for assessment of autoimmune pancreatitis activity: a prospective exploratory study. J Med Ultrason. 2001;2019(46):425–33.
13.
go back to reference Giovannini M, Hookey LC, Bories E, et al. Endoscopic ultrasound elastography: the first step towards virtual biopsy? Preliminary results in 49 patients. Endoscopy. 2006;38:344–8.CrossRef Giovannini M, Hookey LC, Bories E, et al. Endoscopic ultrasound elastography: the first step towards virtual biopsy? Preliminary results in 49 patients. Endoscopy. 2006;38:344–8.CrossRef
14.
go back to reference Itokawa F, Itoi T, Sofuni A, et al. EUS elastography combined with the strain ratio of tissue elasticity for diagnosis of solid pancreatic masses. J Gastroenterol. 2011;46:843–53.CrossRef Itokawa F, Itoi T, Sofuni A, et al. EUS elastography combined with the strain ratio of tissue elasticity for diagnosis of solid pancreatic masses. J Gastroenterol. 2011;46:843–53.CrossRef
15.
go back to reference Itoh Y, Itoh A, Kawashima H, et al. Quantitative analysis of diagnosing pancreatic fibrosis using EUS-elastography (comparison with surgical specimens). J Gastroenterol. 2014;49:1183–92.CrossRef Itoh Y, Itoh A, Kawashima H, et al. Quantitative analysis of diagnosing pancreatic fibrosis using EUS-elastography (comparison with surgical specimens). J Gastroenterol. 2014;49:1183–92.CrossRef
16.
go back to reference Uchida H, Hirooka Y, Itoh A, et al. Feasibility of tissue elastography using transcutaneous ultrasonography for the diagnosis of pancreatic diseases. Pancreas. 2009;38:17–22.CrossRef Uchida H, Hirooka Y, Itoh A, et al. Feasibility of tissue elastography using transcutaneous ultrasonography for the diagnosis of pancreatic diseases. Pancreas. 2009;38:17–22.CrossRef
17.
go back to reference Kawada N, Tanaka S, Uehara H, et al. Feasibility of second-generation transabdominal ultrasound-elastography to evaluate solid pancreatic tumors: preliminary report of 36 cases. Pancreas. 2012;41:978–80.CrossRef Kawada N, Tanaka S, Uehara H, et al. Feasibility of second-generation transabdominal ultrasound-elastography to evaluate solid pancreatic tumors: preliminary report of 36 cases. Pancreas. 2012;41:978–80.CrossRef
18.
go back to reference Janssen J, Schlörer E, Greiner L. EUS elastography of the pancreas: feasibility and pattern description of the normal pancreas, chronic pancreatitis, and focal pancreatic lesions. Gastrointest Endosc. 2007;65:971–8.CrossRef Janssen J, Schlörer E, Greiner L. EUS elastography of the pancreas: feasibility and pattern description of the normal pancreas, chronic pancreatitis, and focal pancreatic lesions. Gastrointest Endosc. 2007;65:971–8.CrossRef
19.
go back to reference Hirche TO, Ignee A, Barreiros AP, et al. Indications and limitations of endoscopic ultrasound elastography for evaluation of focal pancreatic lesions. Endoscopy. 2008;40:910–7.CrossRef Hirche TO, Ignee A, Barreiros AP, et al. Indications and limitations of endoscopic ultrasound elastography for evaluation of focal pancreatic lesions. Endoscopy. 2008;40:910–7.CrossRef
20.
go back to reference Lee TH, Cho YD, Cha SW, et al. Endoscopic ultrasound elastography for the pancreas in Korea: a preliminary single center study. Clin Endosc. 2013;46:172–7.CrossRef Lee TH, Cho YD, Cha SW, et al. Endoscopic ultrasound elastography for the pancreas in Korea: a preliminary single center study. Clin Endosc. 2013;46:172–7.CrossRef
21.
go back to reference Chantarojanasiri T, Hirooka Y, Kawshima H, et al. Endoscopic ultrasound in diagnosis of solid pancreatic lesions: elastography or contrast-enhanced harmonic alone versus the combination. Endosc Int Open. 2017;5:E1136–E1143143.CrossRef Chantarojanasiri T, Hirooka Y, Kawshima H, et al. Endoscopic ultrasound in diagnosis of solid pancreatic lesions: elastography or contrast-enhanced harmonic alone versus the combination. Endosc Int Open. 2017;5:E1136–E1143143.CrossRef
22.
go back to reference Ignee A, Jenssen C, Arcidiacono PG, et al. Endoscopic ultrasound elastography of small solid pancreatic lesions: a multicenter study. Endoscopy. 2018;50:1071–9.PubMed Ignee A, Jenssen C, Arcidiacono PG, et al. Endoscopic ultrasound elastography of small solid pancreatic lesions: a multicenter study. Endoscopy. 2018;50:1071–9.PubMed
23.
go back to reference Kongkam P, Lakananurak N, Navicharern P, et al. Combination of EUS-FNA and elastography (strain ratio) to exclude malignant solid pancreatic lesions: a prospective single-blinded study. J Gastroenterol Hepatol. 2015;30:1683–9.CrossRef Kongkam P, Lakananurak N, Navicharern P, et al. Combination of EUS-FNA and elastography (strain ratio) to exclude malignant solid pancreatic lesions: a prospective single-blinded study. J Gastroenterol Hepatol. 2015;30:1683–9.CrossRef
24.
go back to reference Rustemović N, Kalauz M, Grubelić Ravić K, et al. Differentiation of pancreatic masses via endoscopic ultrasound strain ratio elastography using adjacent pancreatic tissue as the reference. Pancreas. 2017;46:347–51.CrossRef Rustemović N, Kalauz M, Grubelić Ravić K, et al. Differentiation of pancreatic masses via endoscopic ultrasound strain ratio elastography using adjacent pancreatic tissue as the reference. Pancreas. 2017;46:347–51.CrossRef
25.
go back to reference Okasha H, Elkholy S, El-Sayed RW, et al. Real time endoscopic ultrasound elastography and strain ratio in the diagnosis of solid pancreatic lesions. World J Gastroenterol. 2017;23:5962–8.CrossRef Okasha H, Elkholy S, El-Sayed RW, et al. Real time endoscopic ultrasound elastography and strain ratio in the diagnosis of solid pancreatic lesions. World J Gastroenterol. 2017;23:5962–8.CrossRef
26.
go back to reference Kim SY, Cho JH, Kim YJ, et al. Diagnostic efficacy of quantitative endoscopic ultrasound elastography for differentiating pancreatic disease. J Gastroenterol Hepatol. 2017;32:1115–22.CrossRef Kim SY, Cho JH, Kim YJ, et al. Diagnostic efficacy of quantitative endoscopic ultrasound elastography for differentiating pancreatic disease. J Gastroenterol Hepatol. 2017;32:1115–22.CrossRef
27.
go back to reference Săftoiu A, Vilmann P, Gorunescu F, et al. Neural network analysis of dynamic sequences of EUS elastography used for the differential diagnosis of chronic pancreatitis and pancreatic cancer. Gastrointest Endosc. 2008;68:1086–94.CrossRef Săftoiu A, Vilmann P, Gorunescu F, et al. Neural network analysis of dynamic sequences of EUS elastography used for the differential diagnosis of chronic pancreatitis and pancreatic cancer. Gastrointest Endosc. 2008;68:1086–94.CrossRef
28.
go back to reference Săftoiu A, Vilmann P, Gorunescu F, et al. Efficacy of an artificial neural network-based approach to endoscopic ultrasound elastography in diagnosis of focal pancreatic masses. Clin Gastroenterol Hepatol. 2012;10(84–90):e1. Săftoiu A, Vilmann P, Gorunescu F, et al. Efficacy of an artificial neural network-based approach to endoscopic ultrasound elastography in diagnosis of focal pancreatic masses. Clin Gastroenterol Hepatol. 2012;10(84–90):e1.
29.
go back to reference Opačić D, Rustemović N, Kalauz M, et al. Endoscopic ultrasound elastography strain histograms in the evaluation of patients with pancreatic masses. World J Gastroenterol. 2015;21:4014–9.CrossRef Opačić D, Rustemović N, Kalauz M, et al. Endoscopic ultrasound elastography strain histograms in the evaluation of patients with pancreatic masses. World J Gastroenterol. 2015;21:4014–9.CrossRef
30.
go back to reference Iglesias-Garcia J, Larino-Noia J, Abdulkader I, et al. Quantitative endoscopic ultrasound elastography: an accurate method for the differentiation of solid pancreatic masses. Gastroenterology. 2010;139:1172–80.CrossRef Iglesias-Garcia J, Larino-Noia J, Abdulkader I, et al. Quantitative endoscopic ultrasound elastography: an accurate method for the differentiation of solid pancreatic masses. Gastroenterology. 2010;139:1172–80.CrossRef
31.
go back to reference Carrara S, Di Leo M, Grizzi F, et al. EUS elastography (strain ratio) and fractal-based quantitative analysis for the diagnosis of solid pancreatic lesions. Gastrointest Endosc. 2018;87:1464–73.CrossRef Carrara S, Di Leo M, Grizzi F, et al. EUS elastography (strain ratio) and fractal-based quantitative analysis for the diagnosis of solid pancreatic lesions. Gastrointest Endosc. 2018;87:1464–73.CrossRef
32.
go back to reference Goertz RS, Schuderer J, Strobel D, et al. Acoustic radiation force impulse shear wave elastography (ARFI) of acute and chronic pancreatitis and pancreatic tumor. Eur J Radiol. 2016;85:2211–6.CrossRef Goertz RS, Schuderer J, Strobel D, et al. Acoustic radiation force impulse shear wave elastography (ARFI) of acute and chronic pancreatitis and pancreatic tumor. Eur J Radiol. 2016;85:2211–6.CrossRef
33.
go back to reference Onoyama T, Koda M, Fujise Y, et al. Utility of virtual touch quantification in the diagnosis of pancreatic ductal adenocarcinoma. Clin Imaging. 2017;42:64–7.CrossRef Onoyama T, Koda M, Fujise Y, et al. Utility of virtual touch quantification in the diagnosis of pancreatic ductal adenocarcinoma. Clin Imaging. 2017;42:64–7.CrossRef
34.
go back to reference Kitano M, Kudo M, Yamao K, et al. Characterization of small solid tumors in the pancreas: the value of contrast-enhanced harmonic endoscopic ultrasonography. Am J Gastroenterol. 2012;107:303–10.CrossRef Kitano M, Kudo M, Yamao K, et al. Characterization of small solid tumors in the pancreas: the value of contrast-enhanced harmonic endoscopic ultrasonography. Am J Gastroenterol. 2012;107:303–10.CrossRef
Metadata
Title
Present status of ultrasound elastography for the diagnosis of pancreatic tumors: review of the literature
Authors
Takamichi Kuwahara
Kazuo Hara
Nobumasa Mizuno
Shin Haba
Nozomi Okuno
Publication date
01-07-2020
Publisher
Springer Singapore
Published in
Journal of Medical Ultrasonics / Issue 3/2020
Print ISSN: 1346-4523
Electronic ISSN: 1613-2254
DOI
https://doi.org/10.1007/s10396-020-01026-6

Other articles of this Issue 3/2020

Journal of Medical Ultrasonics 3/2020 Go to the issue