Minireviews
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
Artif Intell Gastrointest Endosc. Aug 28, 2021; 2(4): 168-178
Published online Aug 28, 2021. doi: 10.37126/aige.v2.i4.168
Impact of endoscopic ultrasound elastography in pancreatic lesion evaluation
Cosmas Rinaldi Adithya Lesmana, Maria Satya Paramitha
Cosmas Rinaldi Adithya Lesmana, Maria Satya Paramitha, Internal Medicine, Hepatobiliary Division, Dr. Cipto Mangunkusumo National General Hospital, Universitas Indonesia, Jakarta 10430, Daerah Khusus Ibukota, Indonesia
Cosmas Rinaldi Adithya Lesmana, Digestive Disease & GI Oncology Center, Medistra Hospital, Jakarta 12950, Daerah Khusus Ibukota, Indonesia
Author contributions: Lesmana CRA build the idea and wrote the main manuscript; Paramitha MS involved in writing the manuscript.
Conflict-of-interest statement: Authors 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: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Cosmas Rinaldi Adithya Lesmana, FACG, FACP, MD, Senior Lecturer, Internal Medicine, Hepatobiliary Division, Dr. Cipto Mangunkusumo National General Hospital, Universitas Indonesia, Jl. Diponegoro 71 Jakarta, Jakarta 10430, Daerah Khusus Ibukota, Indonesia. medicaldr2001id@yahoo.com
Received: May 25, 2021
Peer-review started: May 25, 2021
First decision: June 18, 2021
Revised: June 20, 2021
Accepted: July 6, 2021
Article in press: July 6, 2021
Published online: August 28, 2021
Processing time: 104 Days and 6.3 Hours
Abstract

Pancreatic malignancy still becomes a major global problem and is considered as one of the most lethal cancers in the field of gastroenterology. Most patients come in the late stage of the disease due to organ’s location, and until now the treatment result is still far away from satisfaction. Early detection is still the main key for good, prolonged survival. However, discerning from other types of tumor sometimes is not easy. Endoscopic ultrasound (EUS) is still the best tool for pancreatic assessment, whereas fine-needle aspiration biopsy (FNAB) is considered as the cornerstone for further management of pancreatic malignancy. Several conditions have become a concern for EUS-FNAB procedure, such as risk of bleeding, pancreatitis, and even needle track-seeding. Recently, an artificial intelligence innovation, such as EUS elastography has been developed to improve diagnostic accuracy in pancreatic lesions evaluation. Studies have shown the promising results of EUS elastography in improving diagnostic accuracy, as well as discerning from other tumor types. However, more studies are still needed with further considerations, such as adequate operator training, expertise, availability, and its cost-effectiveness in comparison to other imaging options.

Keywords: Pancreatic malignancy; Pancreatic lesion; Endoscopic ultrasound; Fine needle aspiration biopsy; Elastography

Core Tip: The application of endoscopic ultrasound (EUS) elastography is one of the most potential roles of artificial intelligence in pancreaticobiliary disorders. EUS elastography becomes a promising method to evaluate pancreatic lesions by providing information of tissue elasticity, which may correlate with malignant characteristics. Incomplete elastographic delineation, especially in large tumor size, as well as compelling intra-/inter-observer variability also still become limitations in performing adequate EUS elastography examination on pancreatic lesions.