Accuracy of Endoscopic Ultrasound (EUS)-Elastography in the Diagnosis of Patients With Early Changes of Chronic Pancreatitis

Aims Evaluate the accuracy of EUS-elastography for the diagnosis of early CP using the ePFT as reference in patients with suspected early CP. Correlation between the degree of pancreatic fibrosis and pancreatic secretion of bicarbonate was also evaluated.

Methods Prospective, cross sectional and observational study. Patients with clinical suspicion of CP and 3-4 EUS criteria of the disease were included. EUS was performed with the slim Pentax Echoendoscope (EG-3270UK) and the HITACHI-Ascendus. Elastographic strain ratio (SR) was evaluated as the mean SR at the head, body and tail of the pancreas. 0.2μg/kg secretin was intravenously administered and bicarbonate concentration was measured in samples of duodenal juice collected at 15, 30 and 45 minutes (normal peak>80 mEq/L). Data are shown as mean±SD and percentages. Diagnostic accuracy of EUS-elastography based on SR for the diagnosis of CP was calculated after drawing the ROC curves, using ePFT as reference method. SR cut-off supporting the diagnosis of early CP was calculated. Correlation between SR and bicarbonate peak was calculated by linear regression analysis.

Results 62 patients were included (mean age 39.9 years, range 18-66, 22 female). Study could be completed in 61 patients. 39 patients (63.9 %) presented 3 EUS criteria for CP, and 22 (36.1 %) presented 4 criteria. Peak bicarbonate concentration was 63.8±23.6 mEq/L, and it was abnormally low in 50 (81.9 %) patients. SR was 3.85±1.24 and it was abnormally high in all patients. ROC analysis yielded an AUC of 0.991 (95 %CI 0.977–1.00). The optimal cut-off of SR for the diagnosis of early CP was 2.88. Sensitivity, specificity and overall accuracy was 92 %, 100 % and 93.4 % respectively. Correlation between SR and bicarbonate secretion was highly significant (r=0.715, p<0.0001).

Conclusions EUS-E can be considered as an accurate method for the diagnosis of early CP, showing a very good correlation with the pancreatic secretion.

Citation: Iglesias-Garcia J, Lariño-Noia J, De la Iglesia-Garcia D et al. OP177 ACCURACY OF ENDOSCOPIC ULTRASOUND (EUS)-ELASTOGRAPHY IN THE DIAGNOSIS OF PATIENTS WITH EARLY CHANGES OF CHRONIC PANCREATITIS. Endoscopy 2021; 53: S72.

Publication History

Article published online:
19 March 2021