Quantitative evaluation of pancreatic tumor fibrosis using shear wave elastography

• Published in: Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.] 2016-11, Vol.16 (6), p.1063-1068
• Main Authors: Kuwahara, Takamichi, Hirooka, Yoshiki, Kawashima, Hiroki, Ohno, Eizaburo, Sugimoto, Hiroyuki, Hayashi, Daijuro, Morishima, Tomomasa, Kawai, Manabu, Suhara, Hiroki, Takeyama, Tomoaki, Yamamura, Takeshi, Funasaka, Kohei, Nakamura, Masanao, Miyahara, Ryoji, Watanabe, Osamu, Ishigami, Masatoshi, Shimoyama, Yoshie, Nakamura, Shigeo, Hashimoto, Senju, Goto, Hidemi
• Format: Article
• Language: English
• Subjects: Accuracy; Adult; Age; Aged; Aged, 80 and over; Body mass index; Chronic pancreatitis; Coronary vessels; Elastic Modulus; Elasticity; Elasticity Imaging Techniques; Endocrinology & Metabolism; Female; Fibrosis; Gastroenterology and Hepatology; Humans; Male; Males; Methods; Middle Aged; Pancreas; Pancreas - diagnostic imaging; Pancreas - pathology; Pancreatectomy; Pancreatic fibrosis; Pancreatic Neoplasms - diagnostic imaging; Pancreatic Neoplasms - pathology; Pancreatic Neoplasms - surgery; Pancreaticoduodenectomy; Pancreatitis, Chronic - diagnosis; Pancreatitis, Chronic - pathology; Reproducibility of Results; Retrospective Studies; ROC Curve; Shear wave elastography; Success; Tumors; Velocity; Young Adult
• ISSN: 1424-3903; 1424-3911
• DOI: 10.1016/j.pan.2016.09.012

Abstract Background & aims There is no established non-invasive method for diagnosis of pancreatic fibrosis. Shear wave elastography (SW-EG) may be a candidate for this purpose. The aims of this study were to assess the reproducibility of SW-EG in the normal imaging pancreas (Phase 1) and to evaluate the diagnostic performance of SW-EG for pancreatic fibrosis classified histologically (Phase 2). Methods Phase 1: This included 127 cases that underwent SW-EG of the normal imaging pancreas. SW-EG was measured at least five times in the pancreatic parenchyma and the median of repeated measurements was defined as the pancreatic elastic modulus (PEM). Phase 2: This included 53 cases that underwent SW-EG of the pancreatic parenchyma preoperatively and in which pancreas parenchyma were evaluated histologically. Histological fibrosis was graded in 4 stages: normal, mild, moderate, and severe. Results Phase 1: Median PEM in the head, body, and tail of the pancreas were 3.23, 3.17, and 2.91 kPa, respectively, with no significant difference among regions ( P  = 0.554). The intraclass correlation coefficient showed good reproducibility (ρ = 0.71) after 5 measurements. Phase 2: There was a significant positive correlation between PEM and the histological pancreatic fibrosis stage (rs  = 0.63, P