The role of endoscopic ultrasound elastography in diagnosis of pancreatic lesions

Objective : To evaluate the accuracy of elastography in differentiating benign from malignant pancreatic masses for patients. Design : A prospective, consecutive, study Setting : Kasr Alini hospital department of internal Medicine , university of Cairo, Egypt. Subjects : Thirty patients had a solid-appearing pancreatic mass at conventional ultrasound, EUS and CT abdomen were included in the study. Results : A total of 30 patients were included in the study. The age of the Patients ranged between 38 and 70 years with a mean value of 54± 8.6 Years. The study included 22 (73.3%) males and eight (26.7%) females. The mean size of pancreatic masses was 35.6 ± 11.8 mm. The final diagnosis were pancreatic adenocarcinoma (n =25) papillary adenocarcinoma (n =1), papillary adenoma (n =2) and chronic pancreatitis ( n =2). The strain ratio was significantly higher among patient with pancreatic malignant tumour compare with those with inflammatory masses. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy for elastograpgy to Differentiate malignant from benign pancreatic masses were: 88%, 80%, 95.6%, 57.14% and 86% respectively (area under receiver operating curve 0 .974). Conclusion : EUS elastography is a useful tool for differentiating malignant from benign pancreatic masses through objective evaluation of tissue stiffness.