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World J Gastrointest Endosc. Oct 16, 2017; 9(10): 506-513
Published online Oct 16, 2017. doi: 10.4253/wjge.v9.i10.506
Endoscopic ultrasound elastography for solid pancreatic lesions
Tanyaporn Chantarojanasiri, Pradermchai Kongkam
Tanyaporn Chantarojanasiri, Department of Medicine, Police General Hospital, Patumwan, Bangkok 10400, Thailand
Pradermchai Kongkam, Gastrointestinal Endoscopy Excellent Center, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok 10330, Thailand
Author contributions: Both authors contributed to this paper.
Conflict-of-interest statement: The authors revealed no conflict of interest in relation to this review.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Pradermchai Kongkam, MD, Gastrointestinal Endoscopy Excellent Center, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, 1873, Rama 4 Road, Patumwan, Bangkok 10330, Thailand. pradermchai.k@chula.ac.th
Telephone: +66-2-2564356 Fax: +66-2-6524219
Received: January 30, 2017
Peer-review started: February 12, 2017
First decision: March 27, 2017
Revised: August 28, 2017
Accepted: September 4, 2017
Article in press: September 5, 2017
Published online: October 16, 2017
Processing time: 255 Days and 21.4 Hours
Abstract

Elastography is one of technologies assisting diagnosis of solid pancreatic lesions (SPL). This technology has been previously used for measuring the stiffness of various organs based on a principle of “harder the lesions, higher chance for malignancy”. Two elastography techniques; strain and shear wave elastography, are available. For endoscopic ultrasound (EUS), only the former is existing. To interpret results of EUS elastography for SPL, 3 methods are used: (1) pattern recognition; (2) strain ratio; and (3) strain histogram. Based on results of existing studies, these 3 techniques provide high sensitivity but low to moderate specificity and accuracy rate. This review will summarize all available information in order to update current situation of using elastography for an evaluation of SPLs to readers.

Keywords: Elastography; Endoscopic ultrasound; Solid pancreatic lesions; Pancreatic cancer; Chronic pancreatitis

Core tip: Elastography is a technology that can measure tissue stiffness. Endoscopic ultrasound (EUS) elastography has been increasingly used for an evaluation of solid pancreatic lesions (SPL). Several interpretation methods of EUS elastography for this purpose have been described in many previous studies. This review focuses on how to read and interpret findings of EUS elastography obtained from SPL. Readers should be competent for applying EUS elastography for diagnosing SPL after finishing reading the review.