Recent Advances in Endosonography—Elastography: Literature Review

Abstract

Ultrasonographic elastography is a modality used to visualize the elastic properties of tissues. Technological advances in ultrasound equipment have supported the evaluation of elastography (EG) in endosonography (EUS). Currently, the usefulness of not only EUS-strain elastography (EUS-SE) but also EUS-shear wave elastography (EUS-SWE) has been reported. We reviewed the literature on the usefulness of EUS-EG for various diseases such as chronic pancreatitis, pancreatic solid lesion, autoimmune pancreatitis, lymph node, and gastrointestinal and subepithelial lesions. The importance of this new diagnostic parameter, “tissue elasticity” in clinical practice might be applied not only to the diagnosis of liver fibrosis but also to the elucidation of the pathogeneses of various gastrointestinal diseases, including pancreatic diseases, and to the evaluation of therapeutic effects. The most important feature of EUS-EG is that it is a non-invasive modality. This is an advantage not found in EUS-guided fine needle aspiration (EUS-FNA), which has made remarkable progress in the field of diagnostics in recent years. Further development of artificial intelligence (AI) is expected to improve the diagnostic performance of EUS-EG. Future research on EUS-EG is anticipated.

Diagnosing chronic pancreatitis by endoscopic ultrasound assessing the association between ultrasound and pathological findings: A narrative review

“…In recent years, EUS‐elastography (EUS‐EG) has become available, further improving the ability of EUS to diagnose fibrosis in CP 32–40 . Actually, EUS‐EG is a more objective method to diagnose fibrosis of the pancreas using EUS 41 . This is a new diagnostic technique for measuring tissue elasticity (stiffness) by application of vibrational energy to the tissue externally, such as manual compression or heartbeat, and for measuring the resulting strain and waves.…”

Endo‐hepatology: The changing paradigm of endoscopic ultrasound in cirrhosis

“…This could be particularly beneficial in patients with increased central adiposity or large-volume ascites where transabdominal elastography may be limited. 28 Contrast-enhanced EUS This modality uses US contrast agents that allow for an enhanced depiction of hepatic vascular architecture. Preliminary results show that contrast-enhanced EUS may improve the detection of left hepatic lobe metastasis from pancreatic neoplasms, when compared with abdominal US and computed tomography of the abdomen.…”

Endoscopic Ultrasound Elastography: New Advancement in Pancreatic Diseases

“…Probably the major outcome of EUS-E is that it may reach structures that are rather hard to examine, such as the pancreas or adjacent lymph nodes. As mentioned above, there are two elastography techniques available on EUS systems that have been tested on pancreatic diseases: strain elastography and the recently introduced shear wave method [11].…”

“…Shear-wave elastography (SWE) also became recently available in the EUS setting [11]. While the concept of SWE is similar to strain elastography, it does not use a transducer to create pressure, but it creates an elasticity map by measuring shear wave parameters.…”

“…By generating shear waves from the transducer, pancreatic tissue is measured and its stiffness becomes more evident as the shear wave velocity is faster. This technique was recently introduced to a EUS setting and might strengthen the available data [11].…”