Gut Liver.  2020 Sep;14(5):659-664. 10.5009/gnl19170.

Utility of Elastography with Endoscopic Ultrasonography Shear-Wave Measurement for Diagnosing Chronic Pancreatitis

• Yamashita Y
• Tanioka K
• Kawaji Y
• Tamura T
• Nuta J
• Hatamaru K
• Itonaga M
• Yoshida T
• Ida Y
• Maekita T
• Iguchi M
• Kitano M

• KMID: 2506441
• DOI: http://doi.org/10.5009/gnl19170

Abstract

Background/Aims
Rosemont classification (RC) with en-doscopic ultrasonography (EUS) is important for diagnosing chronic pancreatitis (CP) but is based only on subjective judgement. EUS shear wave measurement (EUS-SWM) is a precise modality based on objective judgment, but its usefulness has not been extensively studied yet. This study evaluated the utility of EUS-SWM for diagnosing CP and esti-mating CP severity by determining the presence of endocrine dysfunction along with diabetes mellitus (DM).
Methods
Between June 2018 and December 2018, 52 patients who underwent EUS and EUS-SWM were classified into two groups according to RC: non-CP (indeterminate CP and normal) and CP (consistent and suggestive of CP). The EUSSWM value by shear wave velocity was evaluated with a me-dian value. The EUS-SWM value was compared with RC and the number of EUS features. The diagnostic accuracy and cutoff value of EUS-SWM for CP and DM and its sensitivity and specificity were calculated.
Results
The EUS-SWM value significantly positively correlated with the RC and the number of EUS features. The EUS-SWM values that were consistent and suggestive of CP were significantly higher than that of normal. The area under the receiver operating characteristic (AUROC) curve for the diagnostic accuracy of EUS-SWM for CP was 0.97. The cutoff value of 2.19 had 100% sensitivity and 94% specificity. For endocrine dysfunction in CP, the AUROC was 0.75. The cutoff value of 2.78 had 70% sensitiv-ity and 56% specificity.
Conclusions
EUS-SWM provides an objective assessment and can be an alternative diagnostic tool for diagnosing CP. EUS-SWM may also be useful for pre-dicting the presence of endocrine dysfunction.

Keyword

Pancreatitis; chronic; Shear wave EUS elastogra- phy; Rosemont classification; Diabetes mellitus