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Differentiation of Pancreatic Masses via Endoscopic Ultrasound Strain Ratio Elastography Using Adjacent Pancreatic
Nadan Rustemović1, Mirjana Kalauz, Katja Grubelić Ravić
1From the *Department of Gastroenterology, Clinical Hospital Center; †Department of Medicine, Clinical Hospital Center; ‡Clinic for Tumors, Clinical Hospital Center "Sisters of Mercy"; and §Department of Gastroenterology, Clinical Hospital "Merkur," Zagreb, Croatia.
Objectives:
The aims of this study were to evaluate diagnostic value of endoscopic ultrasound strain ratio elastography in patients with focal pancreatic masses and to determine the cutoff value between the pancreatic malignancies and inflammatory pancreatic masses using reference areas different than those used by other investigators.
Methods:
In a prospective single-center study, strain ratio was measured in patients with pancreatic masses. After the diagnosis was established, statistical analysis was used to compare the group with pancreatic malignancies to the one with inflammatory masses.
Results:
Strain ratio cutoff of 7.59 provided 100% sensitivity, 95% specificity, and 97% overall accuracy for differentiation of patients with pancreatic malignancies from those with inflammatory masses.
Conclusions:
Our data show high sensitivity and specificity for the calculated strain ratio. Adjacent normal pancreatic tissue is adequate as a reference area based on the inclusion criteria. Diverse cutoff values and standardization of methods in the studies published so far require further investigations, before the implementation of the method in a routine clinical practice becomes possible.
