Fig. 2

Diagnosis of vascular invasion by Endoscopic ultrasonography Elastography (EUS-EG). a Vascular invasion-negative case. Starting from the left: EUS-EG, EUS B-mode and color Doppler. In B-mode, vascular invasion of the tumor (yellow arrow) is unclear in EUS B-mode image, whereas the colored band (arrow) in EUS-EG image clearly identifies a vascular invasion-negative. b Vascular invasion-positive case. Starting from the left: EUS-EG and EUS-B-mode. In EUS-B-mode, vascular invasion of the tumor is not clear, whereas the absence of a colored band in EUS-EG image permits diagnosis of the site as vascular invasion-positive. c Vascular invasion-negative case in which EUS-EG was effective. Starting from the left: CECT, EUS B-mode and EUS-EG. In CECT, the tumor (yellow arrow) appears to invade the splenic artery. In B-mode, vascular invasion of the tumor (yellow arrow) is unclear in EUS B-mode image, whereas the colored band (arrow) in EUS-EG image clearly identifies a vascular invasion-negative. Pathologically, this case did not infiltrate the splenic artery. CECT: contrast enhanced computed tomography, EUS: endoscopic ultrasonography, EUS-EG: endoscopic ultrasonography elastography