Accuracy of endoscopic ultrasound elastography used for differential diagnosis of focal pancreatic masses: a multicenter study

TY - JOUR

T1 - Accuracy of endoscopic ultrasound elastography used for differential diagnosis of focal pancreatic masses

T2 - a multicenter study

AU - Saftoiu, Adrian

AU - Vilmann, P

AU - Gorunescu, F

AU - Janssen, J

AU - Hocke, Martine

AU - Larsen, M

AU - Iglesias-Garcia, J

AU - Arcidiacono, P

AU - Will, U

AU - Giovannini, M

AU - Dietrich, C

AU - Havre, R

AU - Gheorghe, C

AU - McKay, C

AU - Gheonea, D I

AU - Ciurea, T

AU - European EUS Elastography Multicentric Study Group

AU - Săftoiu, A

N1 - © Georg Thieme Verlag KG Stuttgart · New York.

PY - 2011

Y1 - 2011

N2 - Background and study aims: Endoscopic ultrasound (EUS) elastography represents a new imaging procedure that might characterize the differences of hardness and strain between diseased tissue and normal tissue. The aim of this study was to assess the efficiency of EUS elastography for the differentiation of focal masses in chronic pancreatitis and pancreatic cancer. Patients and methods: The study group comprised 258 patients with focal pancreatic masses included prospectively at 13 participating centers. Qualitative analysis of the diagnoses made by two expert doctors using all recorded video clips was performed in order to test the interobserver variability. A post-processing software analysis was used to examine the EUS elastography videos by calculating average-hue histograms of individual elastography images. The quantitative information was used to calculate intra-observer variability and the accuracy of the method. Results: Qualitative analysis of the recorded videos revealed a kappa value of 0.72. Intra-observer variability analysis revealed that the single measure intraclass correlation ranged between 0.86 and 0.94. The average-hue histogram analysis of the data indicated a sensitivity of 93.4%, a specificity of 66.0%, a positive predictive value of 92.5%, a negative predictive value of 68.9%, and an overall accuracy of 85.4%, based on a cut-off value of 175. Area under the receiver operating characteristic curve (AUROC) was 0.854 (P<0.0001) with a confidence interval of 0.8040.894. Conclusion: The value of quantitative analysis of EUS elastography recordings was proven by good reproducibility of the videos, as well as good parameters of the AUROC analysis.

AB - Background and study aims: Endoscopic ultrasound (EUS) elastography represents a new imaging procedure that might characterize the differences of hardness and strain between diseased tissue and normal tissue. The aim of this study was to assess the efficiency of EUS elastography for the differentiation of focal masses in chronic pancreatitis and pancreatic cancer. Patients and methods: The study group comprised 258 patients with focal pancreatic masses included prospectively at 13 participating centers. Qualitative analysis of the diagnoses made by two expert doctors using all recorded video clips was performed in order to test the interobserver variability. A post-processing software analysis was used to examine the EUS elastography videos by calculating average-hue histograms of individual elastography images. The quantitative information was used to calculate intra-observer variability and the accuracy of the method. Results: Qualitative analysis of the recorded videos revealed a kappa value of 0.72. Intra-observer variability analysis revealed that the single measure intraclass correlation ranged between 0.86 and 0.94. The average-hue histogram analysis of the data indicated a sensitivity of 93.4%, a specificity of 66.0%, a positive predictive value of 92.5%, a negative predictive value of 68.9%, and an overall accuracy of 85.4%, based on a cut-off value of 175. Area under the receiver operating characteristic curve (AUROC) was 0.854 (P<0.0001) with a confidence interval of 0.8040.894. Conclusion: The value of quantitative analysis of EUS elastography recordings was proven by good reproducibility of the videos, as well as good parameters of the AUROC analysis.

U2 - 10.1055/s-0030-1256314

DO - 10.1055/s-0030-1256314

M3 - Journal article

SN - 0013-726X

VL - 43

SP - 596

EP - 603

JO - Endoscopy

JF - Endoscopy

IS - 7

ER -