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 Ohmiya, Yoshiaki Katano, Masatoshi Ishigami, Hidemi Goto, Yoshiki Hirooka

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49 Citations (Scopus)

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 - 07-2014

All Science Journal Classification (ASJC) codes

  • Gastroenterology

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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., Ohmiya, 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, 49(7), 1183-1192. https://doi.org/10.1007/s00535-013-0880-4