Quantitative evaluation of pancreatic tumor fibrosis using shear wave elastography

Takamichi Kuwahara, Yoshiki Hirooka, Hiroki Kawashima, Eizaburo Ohno, Hiroyuki Sugimoto, Daijuro Hayashi, Tomomasa Morishima, Manabu Kawai, Hiroki Suhara, Tomoaki Takeyama, Takeshi Yamamura, Kohei Funasaka, Masanao Nakamura, Ryoji Miyahara, Osamu Watanabe, Masatoshi Ishigami, Yoshie Shimoyama, Shigeo Nakamura, Senju Hashimoto, Hidemi Goto

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32 Citations (Scopus)


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 < 0.001). Areas under the receiver operating characteristic curve for the accuracy of SW-EG for diagnosis of pancreatic fibrosis were 0.85 (≥mild), 0.84 (≥moderate), and 0.87 (severe). Conclusion SW-EG can be used to determine the stage of pancreatic fibrosis non-invasively with high accuracy and reproducibility.

Original languageEnglish
Pages (from-to)1063-1068
Number of pages6
Issue number6
Publication statusPublished - 01-11-2016

All Science Journal Classification (ASJC) codes

  • Endocrinology, Diabetes and Metabolism
  • Hepatology
  • Gastroenterology


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