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World J Gastroenterol. Mar 7, 2022; 28(9): 909-917
Published online Mar 7, 2022. doi: 10.3748/wjg.v28.i9.909
Applications of endoscopic ultrasound elastography in pancreatic diseases: From literature to real life
Clara Benedetta Conti, Giacomo Mulinacci, Raffaele Salerno, Marco Emilio Dinelli, Roberto Grassia
Clara Benedetta Conti, Giacomo Mulinacci, Marco Emilio Dinelli, Interventional Endoscopy Unit, ASST Monza, Ospedale San Gerardo, Monza 20900, Italy
Raffaele Salerno, Gastroenterology and Endoscopy Unit, ASST Fatebenefratelli-Sacco, Milan 20121, Italy
Roberto Grassia, Gastroenterology and Endoscopy Unit, ASST Cremona, Cremona 26100, Italy
Author contributions: Conti CB and Grassia R conceived the idea of the manuscript and supervised the findings of the work; Conti CB and Mulinacci G performed the literature search and wrote the draft of the paper with input from all authors; Salerno R and Dinelli ME verified the methods and the contents; Salerno R and Grassia R provided the illustrations by performing the examinations; All authors discussed the results and contributed to the final manuscript.
Conflict-of-interest statement: Clara Benedetta Conti, Giacomo Mulinacci, Raffaele Salerno, Marco Emilio Dinelli, and Roberto Grassia have no conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Clara Benedetta Conti, MD, Consultant Physician-Scientist, Interventional Endoscopy Unit, ASST Monza, Ospedale San Gerardo, Via G.B. Pergolesi 30, Monza 20900, Italy. benedetta.conti1@gmail.com
Received: September 27, 2021
Peer-review started: September 27, 2021
First decision: November 7, 2021
Revised: November 11, 2021
Accepted: January 29, 2022
Article in press: January 29, 2022
Published online: March 7, 2022
Processing time: 156 Days and 15.8 Hours
Abstract

Elastography is a non-invasive method widely used to measure the stiffness of the tissues, and it is available in most endoscopic ultrasound machines, using either qualitative or quantitative techniques. Endoscopic ultrasound elastography is a tool that should be applied to obtain a complementary evaluation of pancreatic diseases, together with other imaging tests and clinical data. Elastography can be informative, especially when studying pancreatic masses and help the clinician in the differential diagnosis between benign or malignant lesions. However, further studies are necessary to standardize the method, increase the reproducibility and establish definitive cut-offs to distinguish between benign and malignant pancreatic masses. Moreover, even if promising, elastography still provides little information in the evaluation of benign conditions.

Keywords: Elastography; Pancreas; Pancreatic stiffness; Pancreatitis; Pancreatic cancer; Endosonography; Endoscopic ultrasound; Quantitative elastography; Strain elastography; Pancreatic diseases

Core Tip: Elastography is largely available in most endoscopic ultrasound machines, using either qualitative or quantitative methods. The application of elastography in the study of pancreatic diseases should be considered as a complementary test, together with other imaging and clinical data. Elastography can help the clinician in the diagnosis of pancreatic masses, whereas there is still little information in the case of pancreatitis. Further studies are necessary to standardize the method and above all to establish definitive cut-offs to distinguish between benign and malignant pancreatic masses.