Abstract
The study aimed to determine the usefulness of the elastography in the diagnosis of malignancy of solid pancreatic tumors. There were 123 patients (F/M; 51/72, aged 62 ± 14) enrolled into the study with the diagnosis of pancreatic masses. Malignant pancreatic adenocarcinoma was identified in 78 patients and an inflammatory mass corresponding to chronic pancreatitis in the remaining 45 patients. The mass elasticity of a tumor (A–elasticity) and a reference zone (B–elasticity) and the B/A strain ratio were measured. All these elastographic parameters differed between groups and correlated significantly with malignancies (r = 0.841; r = −0.834; r = 0.487, respectively). Receiver operating characteristic (ROC) analysis showed that A–elasticity between 0.05% and 0.14% alone, as well as the B/A strain ratio between 7.87 and 18.23 alone, enabled the recognition of all malignant pancreatic tumors with 100% sensitivity and ≥ 97.8% specificity. Surprisingly, B–elasticity alone also was helpful in recognizing malignant tumors (71% sensitivity, 80% specificity, 0.74 accuracy, and 0.792 area under the curve), although it appeared worse than A–elasticity and B/A strain ratio (p < 0.001). In multivariable regression analysis, A–elasticity identified 89.5% of malignancies (p < 0.001). A–elasticity and B–elasticity were the only significant independent factors influencing the tumor identification (r2 = 0.927; p < 0.001). The assessment of tumor elasticity appears sufficient to identify malignant tumors of the pancreas.
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Funded by grant no. 245 from the Military Institute of Medicine in Warsaw, Poland.
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The authors declare no conflicts of interests in relation to this article.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This study was approved by the Ethics Committee of the Military Institute of Medicine in Warsaw, Poland.
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Dyrla, P. et al. (2018). Elastography in the Diagnosis of Pancreatic Malignancies. In: Pokorski, M. (eds) Advances in Medicine and Medical Research. Advances in Experimental Medicine and Biology(), vol 1133. Springer, Cham. https://doi.org/10.1007/5584_2018_303
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DOI: https://doi.org/10.1007/5584_2018_303
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