Feasibility and usefulness of endoscopic ultrasonography-guided shear-wave measurement for assessment of autoimmune pancreatitis activity: a prospective exploratory study

J Med Ultrason (2001). 2019 Oct;46(4):425-433. doi: 10.1007/s10396-019-00944-4. Epub 2019 Apr 16.

Abstract

Purpose: To assess the feasibility and the clinical usefulness of a newly developed endoscopic ultrasonography (EUS) shear-wave elastography technique (EUS shear-wave measurement: EUS-SWM) in the diagnosis and treatment of autoimmune pancreatitis (AIP).

Methods: Tissue elasticity was measured in the pancreas in 160 patients. The success rate of EUS-SWMs, the velocity of the shear wave (Vs, m/s), and the reliability index of the Vs measurement (VsN) were evaluated, and the elasticity (median Vs) was compared between AIP patients (n = 14) and normal controls.

Results: A total of 3837 EUS-SWMs were performed without adverse events. Overall, 97.6% (3743/3837) were successful. The median VsN was 74%. The median Vs values of the pancreas were as follows: 2.22 m/s in the pancreatic head (push position), 2.36 m/s in the head (pull position), 1.99 m/s in the body, and 2.25 m/s in the tail. The median Vs of the AIP group (2.57 m/s) was significantly higher than that of the normal controls (1.89 m/s) (P = 0.0185). The mean Vs significantly decreased from 3.32 m/s to 2.46 m/s after steroid therapy (n = 6) (P = 0.0234).

Conclusion: EUS-SWM is feasible and generates credible results. EUS-SWM was a useful method for assessment of the effect of steroid therapy in AIP patients.

Keywords: Autoimmune pancreatitis (AIP); EUS elastography; EUS-SWM (EUS shear-wave measurement); Shear-wave elastography.

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Aged
  • Autoimmune Pancreatitis / diagnostic imaging*
  • Autoimmune Pancreatitis / drug therapy
  • Autoimmune Pancreatitis / physiopathology
  • Elasticity Imaging Techniques / methods*
  • Endosonography / methods
  • Feasibility Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pancreas / diagnostic imaging
  • Pancreas / physiopathology
  • Prospective Studies
  • Reproducibility of Results

Substances

  • Adrenal Cortex Hormones