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Lesions were classified as stiff in 91 cases and soft in 35 (kappa coefficient=0.932). The ratio of stiff to soft lesions was significantly higher in PC than in non-PC (623 vs. 2932, P0.001). The sensitivity, specificity, and negative predictive value of a stiff lesion with vs. without MPDD for diagnosis of PC were 94%, 23%, and 50% vs. 100%, 60%, and 100%, respectively. Using the EUS-EG stiffness classification for small SPLs, PC can be excluded with high confidence and concordance for a soft lesion without MPDD. Using the EUS-EG st
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