Pancreatic 2D SWE: a potential tool for non-invasive evaluation of diabetes and diabetic microangiopathy?

Purpose: To determine the pancreatic stiffness values in non-diabetics and diabetic patients using ultrasound shear wave elastography and to associate shear wave elastography values with the presence of diabetic microangiopathy.

Methods: The study included 133 adult participants with 50 non-diabetics and 83 diabetics. Among 83 diabetics, 42 were without and 41 were with diabetic microangiopathy. Pancreatic stiffness was assessed using 2D shear-wave elastography (SWE), with values expressed in kilopascals (kPa) and meters per second (m/s). Measurement reliability was ensured by maintaining an interquartile range-to-median ratio (IQR/M) of ≤ 30% for kPa and ≤ 15% for m/s.

Results: Pancreatic stiffness measured by 2D shear wave elastography was significantly higher in diabetic patients compared to non-diabetic participants, with further elevated values observed in those with microangiopathy. Stiffness values increased proportionally with the number of microangiopathies, with the highest values seen in patients with multiple microangiopathies. ROC curve analysis revealed cutoff values of pancreatic stiffness for predicting diabetes and microangiopathy, demonstra0ting high sensitivity and specificity, with higher stiffness thresholds correlating with the presence of microangiopathy.

Conclusion: These findings highlight the utility of 2D shear wave elastography as a valuable, non-invasive imaging tool for the assessment of pancreatic changes in diabetes and its associated microangiopathic complications.