Progressive fibrosis in chronic pancreatitis (CP) alters the mechanical properties of the pancreatic parenchyma which results in increased tissue stiffness. Endoscopic ultrasound shear-wave elastography (EUS-SWE) quantifies pancreatic stiffness that may help distinguish fibrotic from normal pancreatic tissue.  This prospective study aimed to compare pancreatic shear-wave velocity (Vs) and elasticity (E) values between patients with CP and individuals with a normal pancreas.

In this single centred study of 7 months duration, 42 consecutive adults undergoing EUS for evaluation of CP or for non-pancreatic indications were enrolled. Participants were classified into a CP group (n=20) based on imaging and tests of pancreatic insufficiency and a control group (n= 22) with normal pancreatic morphology. During EUS, Vs was measured in metres/second(m/s) and E in kilopascals (kPa) using the Olympus EUS ME3 system. Mean values were compared between groups, and diagnostic performance was assessed using receiver operating characteristic (ROC) analysis and statistical significance was considered with a p value less than 0.05.

The mean age of the CP group was 41.35 years and the control group was 43 years. Majority of the CP cases were males (n=13). The mean Vs of the CP group was 2.46+0.3 m/s which was significantly higher than that of the control group which was 1.89+0.37 (p<0.05). A Vs value of 2.2 m/s was 95% sensitive and 82% specific for predicting CP with area under ROC (AUROC) of 0.88. Similarly, mean E value of CP group 19.03+1.59 kPa was also significantly higher than the control group which was 12.16+5.30 kPa (p<0.05). An E value of 17.5 kPa was 85% sensitive and 82% specific for predicting CP with AUROC of 0.87.

In the present study EUS-SWE reliably distinguished chronic pancreatitis from normal pancreas by demonstrating significantly higher levels of tissue stiffness in CP thereby emphasising the role of EUS-SWE as a useful adjunctive tool for quantification of pancreatic fibrosis in patients of CP.