Ultrasound-based point shear wave elastography across chronic pancreatitis severities, pancreatic ductal adenocarcinoma, and healthy control: an exploratory Egyptian cohort study

Background Chronic pancreatitis (CP) and Pancreatic Ductal Adenocarcinoma (PDA) are associated with increased tissue stiffness due to fibrosis. This study evaluates the effectiveness of point Shear Wave Elastography (p-SWE) in assessing CP and PDA, and comparing this modality with conventional imaging methods. Methods Thirty patients with pancreatic cancer, 20 with CP, and 30 healthy controls participated in this prospective cross-sectional diagnostic study with a healthy control comparative group. Demographic, laboratory, and radiological data were collected. Tissue elasticity was measured using p-SWE and compared with disease severity and radiological assessments. Results Shear wave velocity by p-SWE was highest in PDA, followed by CP, and controls (3.5, 2.7, and 1.2 m/s, respectively; p < 0.001). In predicting PDA versus chronic pancreatitis, p-SWE had an AUC of 0.804 at a cut-off value of > 2.5, with an overall accuracy of 84%. Patients with marked CP (based on CT criteria) had significantly greater shear wave velocity than those with moderate CP (3.2 vs. 2.3 m/s; p < 0.001). Conclusions p-SWE is a promising a complementary tool for characterizing pancreatic stiffness across healthy controls, chronic pancreatitis, and PDA. However, larger prospective studies are needed to establish validated cut-offs and confirm its diagnostic accuracy in clinical practice.