Endoscopic ultrasound in oncology: An update of clinical applications in the gastrointestinal tract

Figure 4 A lymph node being evaluated by elastography, for a gastric tumor staging. A: Qualitative elastography (color tones red-green-blue) shows the lesion with a blue-predominant color tone, which represents a hard tissue and suggest malignancy. The Strain Ratio (quantitative elastography) is being calculated by compering two different areas (A and B). Area A includes as much of the target lesion as possible. Area B is selected within a soft (red) reference area outside the target lesion. The result (B/A = 141.7) suggests malignancy; B: Shows the round, sharply demarcated and hypoechoic lymph node (white arrow). The endoscopic ultrasound-elastography was done using a Hitachi-Avius console with a radial scope EG-3630URK (from Pentax Medical).