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Quantitative elastography on par with fine-needle aspiration in evaluating pancreatic solid masses

03 Aug 2019

It appears that quantitative elastography (QE) is as good as fine-needle aspiration (FNA) in the assessment of pancreatic solid masses (PSMs), but the former can be used as a potential alternative of the latter in cases where the new strain ratio (SR) cutoff-based classifications are applied, suggests a study.

A total of 134 patients (mean age, 53 years; 53 percent women) were included, with a median tumour size of 30 (10–78) mm. Of these, 69.4 percent were malignant and 30.6 percent were benign tumours (median SR, 19.5 vs 7.5; p=0.000), and 87 percent were pancreatic adenocarcinoma.

In both PSM types, parameters were comparable between QE with SR cutoff ≥10 and FNA (for malignant tumour: sensitivity, 94 percent in both; specificity, 85 percent vs 87 percent; positive predictive value, 93 percent vs 94 percent; negative predictive value, 87 percent in both; and accuracy, 92 percent; for benign tumour: sensitivity, 85 percent vs 87 percent; specificity, 94 percent in both; positive predictive value, 87 percent in both; negative predictive value, 93 percent vs 94 percent; accuracy, 92 percent).

The area under the curve was 0.96 (95 percent CI, 0.940–0.995; p<0.000). New classifications based on positive likelihood ratio were created: A ≤8.7 (benign tumour), B >8.7 to <15.5 (indeterminate), and C ≥15.5 (malignant tumour).

This prospective study was conducted between January and December 2016 and included patients with suspected PSM. Those with advanced disease and cystic components were excluded. Both QE and FNA were performed, and histologic information was obtained for the final diagnoses. The authors then calculated diagnostic tests and receiver-operating characteristic curve.

“[E]ndoscopic ultrasound with FNA enables tissue acquisition but has high false-negative rates, [while] QE predicts diagnosis on the basis of the SR,” the authors said.

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Most Read Articles
Yesterday
Administering intranasal desmopressin to patients with renal dysfunction not requiring haemodialysis reduces bleeding complications during renal biopsies, especially minor complications such as perinephric haematomas, a study has found. However, it may increase the risk of incident hyponatraemia.
Pearl Toh, 10 Oct 2019
Adding a LAMA* to the double combination therapy of ICS** plus LABA*** in a single inhaler improves lung function and reduces exacerbations in patients whose asthma is inadequately controlled with the combination treatment, according to the TRIMARAN and TRIGGER# studies presented at ERS 2019.
3 days ago
Environmental quality and exposure to pollution may play a small part in the development of metabolic diseases, such as diabetes, a new study has found.
Tristan Manalac, 5 days ago
Sleep deprivation impairs adolescents’ long-term retention of classroom material, according to a recent Singapore study.