Quantitative analysis of diagnosing pancreatic fibrosis using EUS-elastography (comparison with surgical specimens)

Yuya Itoh, Akihiro Itoh, Hiroki Kawashima, Eizaburo Ohno, Yosuke Nakamura, Takeshi Hiramatsu, Hiroyuki Sugimoto, Hajime Sumi, Daijuro Hayashi, Takamichi Kuwahara, Tomomasa Morishima, Kohei Funasaka, Masanao Nakamura, Ryoji Miyahara, Naoki Omiya, Yoshiaki Katano, Masatoshi Ishigami, Hidemi Goto, Yoshiki Hirooka

Research output: Contribution to journalArticle

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Abstract

Background: An accurate diagnosis of pancreatic fibrosis is clinically important and may have potential for staging chronic pancreatitis. The aim of this study was to diagnose the grade of pancreatic fibrosis through a quantitative analysis of endoscopic ultrasound elastography (EUS-EG). Methods: From September 2004 to October 2010, 58 consecutive patients examined by EUS-EG for both pancreatic tumors and their upstream pancreas before pancreatectomy were enrolled. Preoperative EUS-EG images in the upstream pancreas were statistically quantified, and the results were retrospectively compared with postoperative histological fibrosis in the same area. For the quantification of EUS-EG images, 4 parameters (mean, standard deviation, skewness, and kurtosis) were calculated using novel software. Histological fibrosis was graded into 4 categories (normal, mild fibrosis, marked fibrosis, and severe fibrosis) according to a previously reported scoring system. Results: The fibrosis grade in the upstream pancreas was normal in 24 patients, mild fibrosis in 19, marked fibrosis in 6, and severe fibrosis in 9. Fibrosis grade was significantly correlated with all 4 quantification parameters (mean r = -0.75, standard deviation r = -0.54, skewness r = 0.69, kurtosis r = 0.67). According to the receiver operating characteristic analysis, the mean was the most useful parameter for diagnosing pancreatic fibrosis. Using the mean, the area under the ROC curves for the diagnosis of mild or higher-grade fibrosis, marked or higher-grade fibrosis and severe fibrosis were 0.90, 0.90, and 0.90, respectively. Conclusions: An accurate diagnosis of pancreatic fibrosis may be possible by analyzing EUS-EG images.

Original languageEnglish
Pages (from-to)1183-1192
Number of pages10
JournalJournal of Gastroenterology
Volume49
Issue number7
DOIs
Publication statusPublished - 01-01-2014
Externally publishedYes

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Elasticity Imaging Techniques
Fibrosis
Pancreas
ROC Curve
Pancreatectomy

All Science Journal Classification (ASJC) codes

  • Gastroenterology

Cite this

Itoh, Yuya ; Itoh, Akihiro ; Kawashima, Hiroki ; Ohno, Eizaburo ; Nakamura, Yosuke ; Hiramatsu, Takeshi ; Sugimoto, Hiroyuki ; Sumi, Hajime ; Hayashi, Daijuro ; Kuwahara, Takamichi ; Morishima, Tomomasa ; Funasaka, Kohei ; Nakamura, Masanao ; Miyahara, Ryoji ; Omiya, Naoki ; Katano, Yoshiaki ; Ishigami, Masatoshi ; Goto, Hidemi ; Hirooka, Yoshiki. / Quantitative analysis of diagnosing pancreatic fibrosis using EUS-elastography (comparison with surgical specimens). In: Journal of Gastroenterology. 2014 ; Vol. 49, No. 7. pp. 1183-1192.
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abstract = "Background: An accurate diagnosis of pancreatic fibrosis is clinically important and may have potential for staging chronic pancreatitis. The aim of this study was to diagnose the grade of pancreatic fibrosis through a quantitative analysis of endoscopic ultrasound elastography (EUS-EG). Methods: From September 2004 to October 2010, 58 consecutive patients examined by EUS-EG for both pancreatic tumors and their upstream pancreas before pancreatectomy were enrolled. Preoperative EUS-EG images in the upstream pancreas were statistically quantified, and the results were retrospectively compared with postoperative histological fibrosis in the same area. For the quantification of EUS-EG images, 4 parameters (mean, standard deviation, skewness, and kurtosis) were calculated using novel software. Histological fibrosis was graded into 4 categories (normal, mild fibrosis, marked fibrosis, and severe fibrosis) according to a previously reported scoring system. Results: The fibrosis grade in the upstream pancreas was normal in 24 patients, mild fibrosis in 19, marked fibrosis in 6, and severe fibrosis in 9. Fibrosis grade was significantly correlated with all 4 quantification parameters (mean r = -0.75, standard deviation r = -0.54, skewness r = 0.69, kurtosis r = 0.67). According to the receiver operating characteristic analysis, the mean was the most useful parameter for diagnosing pancreatic fibrosis. Using the mean, the area under the ROC curves for the diagnosis of mild or higher-grade fibrosis, marked or higher-grade fibrosis and severe fibrosis were 0.90, 0.90, and 0.90, respectively. Conclusions: An accurate diagnosis of pancreatic fibrosis may be possible by analyzing EUS-EG images.",
author = "Yuya Itoh and Akihiro Itoh and Hiroki Kawashima and Eizaburo Ohno and Yosuke Nakamura and Takeshi Hiramatsu and Hiroyuki Sugimoto and Hajime Sumi and Daijuro Hayashi and Takamichi Kuwahara and Tomomasa Morishima and Kohei Funasaka and Masanao Nakamura and Ryoji Miyahara and Naoki Omiya and Yoshiaki Katano and Masatoshi Ishigami and Hidemi Goto and Yoshiki Hirooka",
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Itoh, Y, Itoh, A, Kawashima, H, Ohno, E, Nakamura, Y, Hiramatsu, T, Sugimoto, H, Sumi, H, Hayashi, D, Kuwahara, T, Morishima, T, Funasaka, K, Nakamura, M, Miyahara, R, Omiya, N, Katano, Y, Ishigami, M, Goto, H & Hirooka, Y 2014, 'Quantitative analysis of diagnosing pancreatic fibrosis using EUS-elastography (comparison with surgical specimens)', Journal of Gastroenterology, vol. 49, no. 7, pp. 1183-1192. https://doi.org/10.1007/s00535-013-0880-4

Quantitative analysis of diagnosing pancreatic fibrosis using EUS-elastography (comparison with surgical specimens). / Itoh, Yuya; Itoh, Akihiro; Kawashima, Hiroki; Ohno, Eizaburo; Nakamura, Yosuke; Hiramatsu, Takeshi; Sugimoto, Hiroyuki; Sumi, Hajime; Hayashi, Daijuro; Kuwahara, Takamichi; Morishima, Tomomasa; Funasaka, Kohei; Nakamura, Masanao; Miyahara, Ryoji; Omiya, Naoki; Katano, Yoshiaki; Ishigami, Masatoshi; Goto, Hidemi; Hirooka, Yoshiki.

In: Journal of Gastroenterology, Vol. 49, No. 7, 01.01.2014, p. 1183-1192.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Quantitative analysis of diagnosing pancreatic fibrosis using EUS-elastography (comparison with surgical specimens)

AU - Itoh, Yuya

AU - Itoh, Akihiro

AU - Kawashima, Hiroki

AU - Ohno, Eizaburo

AU - Nakamura, Yosuke

AU - Hiramatsu, Takeshi

AU - Sugimoto, Hiroyuki

AU - Sumi, Hajime

AU - Hayashi, Daijuro

AU - Kuwahara, Takamichi

AU - Morishima, Tomomasa

AU - Funasaka, Kohei

AU - Nakamura, Masanao

AU - Miyahara, Ryoji

AU - Omiya, Naoki

AU - Katano, Yoshiaki

AU - Ishigami, Masatoshi

AU - Goto, Hidemi

AU - Hirooka, Yoshiki

PY - 2014/1/1

Y1 - 2014/1/1

N2 - Background: An accurate diagnosis of pancreatic fibrosis is clinically important and may have potential for staging chronic pancreatitis. The aim of this study was to diagnose the grade of pancreatic fibrosis through a quantitative analysis of endoscopic ultrasound elastography (EUS-EG). Methods: From September 2004 to October 2010, 58 consecutive patients examined by EUS-EG for both pancreatic tumors and their upstream pancreas before pancreatectomy were enrolled. Preoperative EUS-EG images in the upstream pancreas were statistically quantified, and the results were retrospectively compared with postoperative histological fibrosis in the same area. For the quantification of EUS-EG images, 4 parameters (mean, standard deviation, skewness, and kurtosis) were calculated using novel software. Histological fibrosis was graded into 4 categories (normal, mild fibrosis, marked fibrosis, and severe fibrosis) according to a previously reported scoring system. Results: The fibrosis grade in the upstream pancreas was normal in 24 patients, mild fibrosis in 19, marked fibrosis in 6, and severe fibrosis in 9. Fibrosis grade was significantly correlated with all 4 quantification parameters (mean r = -0.75, standard deviation r = -0.54, skewness r = 0.69, kurtosis r = 0.67). According to the receiver operating characteristic analysis, the mean was the most useful parameter for diagnosing pancreatic fibrosis. Using the mean, the area under the ROC curves for the diagnosis of mild or higher-grade fibrosis, marked or higher-grade fibrosis and severe fibrosis were 0.90, 0.90, and 0.90, respectively. Conclusions: An accurate diagnosis of pancreatic fibrosis may be possible by analyzing EUS-EG images.

AB - Background: An accurate diagnosis of pancreatic fibrosis is clinically important and may have potential for staging chronic pancreatitis. The aim of this study was to diagnose the grade of pancreatic fibrosis through a quantitative analysis of endoscopic ultrasound elastography (EUS-EG). Methods: From September 2004 to October 2010, 58 consecutive patients examined by EUS-EG for both pancreatic tumors and their upstream pancreas before pancreatectomy were enrolled. Preoperative EUS-EG images in the upstream pancreas were statistically quantified, and the results were retrospectively compared with postoperative histological fibrosis in the same area. For the quantification of EUS-EG images, 4 parameters (mean, standard deviation, skewness, and kurtosis) were calculated using novel software. Histological fibrosis was graded into 4 categories (normal, mild fibrosis, marked fibrosis, and severe fibrosis) according to a previously reported scoring system. Results: The fibrosis grade in the upstream pancreas was normal in 24 patients, mild fibrosis in 19, marked fibrosis in 6, and severe fibrosis in 9. Fibrosis grade was significantly correlated with all 4 quantification parameters (mean r = -0.75, standard deviation r = -0.54, skewness r = 0.69, kurtosis r = 0.67). According to the receiver operating characteristic analysis, the mean was the most useful parameter for diagnosing pancreatic fibrosis. Using the mean, the area under the ROC curves for the diagnosis of mild or higher-grade fibrosis, marked or higher-grade fibrosis and severe fibrosis were 0.90, 0.90, and 0.90, respectively. Conclusions: An accurate diagnosis of pancreatic fibrosis may be possible by analyzing EUS-EG images.

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JO - Journal of Gastroenterology

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