Utility of EUS elastography in the diagnosis of gastric subepithelial tumors: a pilot study (with video)

Published:September 17, 2019DOI:

      Background and Aims

      EUS elastography is a real-time imaging technique that analyzes tissue elasticity. The aim of this study was to investigate the applicability of quantitative EUS elastography in the differential diagnosis of gastric subepithelial tumors (SETs).


      We prospectively registered 41 consecutive patients with gastric SETs and measured their strain ratios with EUS elastography. The strain ratios of gastric SETs were compared with the histopathologic diagnosis.


      Thirty-one patients (mean age, 51.4 ± 12.6 years) were included in the analysis. The mean size of the SETs was 2.3 ± 0.7 cm. Lipomas had the lowest strain ratio of 1.6 (1.1-2.0), followed by leiomyomas 6.0 (2.0-29.0), ectopic pancreas 11.8 (1.7-29.3), gastrointestinal stromal tumors (GISTs) 51.1 (29.0-67.0), and schwannomas 62.0. With a cut-off value of 22.7, EUS elastography could differentiate GISTs from leiomyomas with sensitivity and specificity of 100% and 94.1%, respectively (P = .001; 95% confidence interval, 0.979-1.000).


      EUS elastography could be a promising diagnostic adjunct for the assessment of gastric SETs, especially in differentiating GISTs from leiomyomas.

      Graphical abstract


      APC (argon plasma coagulation), CEEUS (contrast-enhanced EUS), EUS-FNB (EUS fine needle biopsy), EUS-TCB (EUS-guided trucut biopsy), GIST (gastrointestinal stromal tumor), IT knife (insulation-tipped knife), ROC (receiver operating characteristic), ROI (region of interest), SET (subepithelial tumor)
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