Diagnostic performance of EUS for chronic pancreatitis: a comparison with histopathology

Usefulness of percutaneous elastography by acoustic radiation force impulse for the non-invasive diagnosis of chronic pancreatitis

“…But these studies have many limitations such as the inclusion of patients with a high probability pre-test for CP in the presence of high risk factors (7), including patients with surgical resection for cancer (8), and variability in the number of criteria used to define CP by EUS and histology (9). Our series found a significant correlation between the number of EUS criteria, mainly parenchymal and SWV in the head and body of the pancreas (Table III).…”

“…Using histology as a reference, EUS criteria have been evaluated for non-calcifying CP, reporting sensitivities between 75-91% and 85-100% of specificity (7)(8)(9)(10)(11). But these studies have many limitations such as the inclusion of patients with a high probability pre-test for CP in the presence of high risk factors (7), including patients with surgical resection for cancer (8), and variability in the number of criteria used to define CP by EUS and histology (9).…”

“…There is a significant correlation between the number of criteria of CP by EUS and the degree of pancreatic fibrosis histologically evaluated (7)(8)(9)(10)(11). Another way to indirectly assess the degree of tissue stiffness is by elastography, which is the representation of images of the mechanical properties of objects (elasticity) when exposed to a force tending to deform (12).…”

Endosonographic Diagnosis of Chronic Pancreatitis

“…The characteristic imaging findings for early CP were set as the following seven EUS features (five parenchymal and two ductal features): (1) lobularity with honeycombing, (2) lobularity without honeycombing, (3) hyperechoic foci without shadowing, (4) stranding, (5) cysts, (6) dilated side branches, and (7) hyperechoic main pancreatic duct (MPD) margin [15] (Table 3). More than two among the seven features including any of (1)-(4), which are most likely to reflect fibrous changes in pancreatic parenchyma, are judged to be sufficient for the EUS findings of early CP [9][10][11][12]20,21]. It remains as a challenge for future study to ascertain whether early CP diagnosed using these criteria progress to advanced CP.…”

Total Pancreatectomy and Islet Autotransplantation for Chronic Pancreatitis

“…Further support for the contention that the current criteria, designed to prevent overdiagnosing CP on EUS (Sahai et al, 1998), may under-diagnose comes from Chong and colleagues (Chong et al, 2007)at the Medical University of South Carolina. They found that a threshold of three criteria gave the best balance between sensitivity (83%) and specificity (80%) for correlation of EUS findings with histological CP.…”