Gastro/EUS

Real-time Tissue Elastography (RTE)
Endoscopic RTE allows benign and malignant lymph nodes to be characterised and differentiated – with high sensitivity, specificity and accuracy. This provides complementary information to the conventional EUS imaging and offers a better target for FNA in patients with multiple lymph nodes. Mapping of the tissues’ elasticity distribution can provide more information to aid in the differentiation of focal pancreatic masses."

1. Dietrich C.F., et al. Sonographic assessment of splanchnic arteries and the bowel wall. Eur J Radiol. 2007 Nov;64(2):202-12
2. Dietrich C.F., Hirche T. O., Ott M., et al. Real-time tissue elastography in the diagnosis of autoimmune pancreatitis. Endoscopy 2009; 41: 718–720
3. Friedrich-Rust M., Ong M.F., Herrmann E., et al. Real-time elastography for noninvasive assessment of liver fibrosis in chronic viral hepatitis. AJR 2007; 188:758–764
4. Friedrich-Rust M., Schwarz A., Ong M.F., et al. Real-time tissue elastography versus Fibroscan for noninvasive assessment of liver fibrosis in chronic liver disease. Ultraschall in Med 2009; 30: 478 - 484
5. Friedrich-Rust M, Sperber A, Holzer K, et al. Real-time elastography and contrast-enhanced ultrasound for the assessment of thyroid nodules. Exp Clin Endocrinol Diabetes. 2009 Oct 23. [Epub ahead of print]
6. Gheonea DI, Saftoiu A, Ciurea T, et al. Real-time sono-elastography in the diagnosis of diffuse liver diseases. World J Gastroenterol. 2010 Apr 14;16(14):1720-6.
7. Gheorghe L., Iacob S., Gheorghe C. Real-time sonoelastography - a new application in the field of liver disease. J Gastrointestin Liver Dis, December 2008 Vol.17 No 4, 469-474
8. Giovannini M., Hookey L.C ., Bories E., et al. Endoscopic ultrasound elastography: the first step towards virtual biopsy? Preliminary results in 49 patients. Endoscopy 2006; 38:1-5
9. Giovannini M., Botelberge T., Bories E., et al. Endoscopic ultrasound elastography for evaluation of lymph nodes and pancreatic masses: a multicenter study. World J Gastroenterol 2009 April 7; 15(13): 1587-1593
10. Havre R.F., Elde E., Gilja O.H., et al. Freehand real-time elastography: impact of scanning parameters on image quality and in vitro intra- and interobserver validations. Ultrasound Med Biol. 2008 Oct;34(10):1638-50.
11. Hirche T.O., Ignee A., Barreiros A. P., et al. Indications and limitations of endoscopic ultrasound elastography for evaluation of focal pancreatic lesions. Endoscopy 2008; 40: 910-917
12. Jacobson B. Pressed for an answer: has elastography finally come to EUS? Gastrointest Endosc 2007;66(2):301-2
13. Janssen J., Schlörer E., Greiner L. EUS elastography of the pancreas: feasibility and pattern description of the normal pancreas, chronic pancreatitis, and focal pancreatic lesions. Gastrointest Endosc 2007;65:971-8.
14. Janssen J., Dietrich C. F., Will U., et al. Endosonographic elastography in the diagnosis of mediastinal lymph nodes. Endoscopy 2007; 39: 952-957
15. Janssen J. Us elastography: current status and perspectives. [Article in German] Gastroenterol. 2008 Jun;46(6):572-9
16. Kato K., Sugimoto H., Kanazumi N., et al. Intra-operative application of real-time tissue elastography for the diagnosis of liver tumours. Liver International ISSN 1478-3223
17. Mezzi G., Arcidiacono P. G., Carrara S., et al. Elastosonography in malignant rectal disease: preliminary data. Endoscopy 2007; 39: 375
18. Saftoiu A., Vilman P. Endoscopic ultrasound elastography - a new imaging technique for the visualization of tissue elasticity distribution. J Gastrointestinal Liver Disease, June 2006;15 (2):161-165
19. Saftoiu A., Vilman P., Hassan F., et al. Analysis of endoscopic ultrasound elastography used for characterisation and differentiation of benign and malignant lymph nodes. Ultraschall in Med 2006;27:535 – 542
20. Saftoiu A., Vilman P., Ciurea T., et al. Dynamic analysis of EUS used for the differentiation of benign and malignant lymph nodes. Gastrointest Endosc 2007; 66 (2): 291 – 300
21. Saftoiu A., Vilmann P., Gorunescu F., et al. Neural network analysis of dynamic sequences of EUS elastography used for the differential diagnosis of chronic pancreatitis and pancreatic cancer. Gastrointest Endosc 2008;68:1086-94
22. Tatsumi C, Kudo M, Ueshima K, et al. Non-invasive evaluation of hepatic fibrosis for type C chronic hepatitis. Intervirology. 2010;53(1):76-81. Epub 2010 Jan 5.
23. Uchida H., Hirooka Y., Itoh A., et al. Feasibility of Tissue Elastography Using Transcutaneous Ultrasonography for the Diagnosis of Pancreatic Diseases. Pancreas 2009;38(1):17-22
24. Recommended reading:
    Endoscopic Ultrasound: An Introductory Manual and Atlas
    Editor: Christoph Frank Dietrich
    Published Thieme, 2006
    Atlas of Endoscopic Ultrasonography. The Upper Gastrointestinal Tract.
    Svein Ødegaard, Lars Birger Nesje,Odd Helge Gilja
    Published Fagbokforlaget 2007