Two-dimensional shear wave elastography of the pancreas: measurement success rate, repeatability, and factors affecting measurement values

Purpose We aimed to evaluate the success rate, repeatability, and factors affecting the measurement values of two-dimensional ultrasonic shear wave elastography (2D-SWE) for measuring pancreatic stiffness. Methods This prospective study recruited 100 healthy participants. 2D-SWE was performed on the pancreatic head, body, and tail. We compared the success rates of pancreatic stiffness measurements of different body positions and ultrasonic scans, with and without probe pressurization, as well as the effects of sex, age, body mass index (BMI), and region of interest (ROI) depth on measurement values. Intra- and inter-operator repeatabilities were assessed in 20 participants. The influence of ROI depth was verified using a tissue-like phantom. Results The median 2D-SWE measurements of the pancreatic head, body, and tail were 1.44, 1.45, and 1.56 m/s, respectively. The success rates for the pancreatic head and body were significantly higher than that of the tail. The success rate for the semi-recumbent position was higher than that of the supine position ( P < 0.001). The intra-operator values for same-day and inter-operator reliability were excellent. Univariate analyses showed that probe pressurization, age, BMI, and ROI depth were correlated with pancreatic shear wave velocity (SWV) ( P < 0.05); only ROI depth had a significant effect on SWV values. The inclusion phantom showed that the SWV value increased as the ROI depth increased. Conclusions 2D-SWE had a high success rate and good repeatability for measuring pancreatic head and body stiffness. The ROI depth was the main factor affecting pancreatic SWV, which increased with ROI depth.