Endoscopy 2006; 38(4): 344-348
DOI: 10.1055/s-2006-925158
Original Article
© Georg Thieme Verlag KG Stuttgart · New York

Endoscopic Ultrasound Elastography: the First Step towards Virtual Biopsy? Preliminary Results in 49 Patients

M.  Giovannini1 , L.  C.  Hookey1 , E.  Bories1 , C.  Pesenti1 , G.  Monges1 , J.  R.  Delpero1
  • 1Endoscopic Unit, Paoli-Calmettes Institute, Marseilles, France
Further Information

Publication History

Submitted 21 June 2005

Accepted after revision 19 December 2005

Publication Date:
05 May 2006 (online)

Background and Study Aims: It is well known that some diseases, such as cancer, lead to changes in the hardness of tissue. Sonoelastography, a technique that allows the elasticity of tissue to be assessed during ultrasound examination, provides the ultrasonographer with important additional information that can be used for diagnosis. The aim of this study was to evaluate the ability of endoscopic ultrasound elastography to differentiate between benign and malignant pancreatic masses and lymph nodes.
Patients and Methods: During a 12-month period, 49 patients underwent endoscopic ultrasound (EUS) examinations with elastography, conducted by a single endoscopist. Twenty-four patients underwent evaluation of a pancreatic mass (mean diameter 24.7 ± 11.1mm) and 25 underwent evaluation of 31 lymph nodes. The mean diameter of the lymph nodes was 19.7 ± 8.6 mm, and they were found in the cervical area (n = 3), mediastinum (n = 17), celiac arterial trunk region (n = 5), and aortocaval region (n = 6).
Results: The sonoelastography images of pancreatic masses were interpreted as benign in four cases and malignant in 20. The sensitivity and specificity of sonoelastography in the diagnosis of malignant lesions were 100 % and 67 %, respectively. The sonoelastography images of the lymph nodes were interpreted as showing malignancy in 22 cases, benign conditions in seven, and indeterminate status in two. The sensitivity and specificity of sonoelastography for evaluating malignant lymph-node invasion were 100 % and 50 %, respectively.
Conclusions: EUS elastography is potentially capable of further defining the tissue characteristics of benign and malignant lesions but specifity has to be improved. It can be used to guide biopsy sampling for diagnosis.


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M. Giovannini, M. D.

Endoscopic Unit, Paoli-Calmettes Institute

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Email: hdjchir@marseille.fnclcc.fr