Role of endoscopic ultrasound elastography in differential diagnosis of pancreatic solid masses

Introduction: Endoscopic ultrasound (EUS) elastography is another technique that measures the stiffness of tissue and adds more diagnostic value to EUS. Objective: This study aimed to assess the ability of qualitative and quantitative EUS elastography in differentiating malignant from benign solid pancreatic masses. Methods: This 2-year cross-sectional study enrolled 80 patients with solid pancreatic masses in the department of endoscopy in Alassad University Hospital who underwent conventional and elastography-assisted EUS and then followed for pathology through EUS-guided or CT-guided biopsy or surgery. Results: Qualitative elastography using a 5-point scoring system was able to recognize malignant pathology (obtained by EUS-guided biopsy, CT-guided biopsy, or surgery) with a sensitivity, specificity, and accuracy rates of 100%, 28.6%, and 81.3%, respectively. A quantitative method using hue histogram had a sensitivity of 71.2%–86.4% and specificity of 71.4%–81% with the best accuracy for histogram mean ratio (area under the curve, 0.867). Conclusion: EUS elastography is a simple and good alternative method in differentiating malignant from benign pancreatic solid masses.