A Comparative Study of Endoscopic Ultrasound Guided Fine Needle Aspiration With and Without a Stylet

Wani, Sachin; Gupta, Neil; Gaddam, Srinivas; Singh, Vikas; Ulusaraç, Ozlem; Romanas, Maria M.; Bansal, Ajay; Sharma, Prateek; Olyaee, Mojtaba; Rastogi, Amit

doi:10.1007/s10620-011-1608-z

Cited by 77 publications

(69 citation statements)

References 29 publications

(27 reference statements)

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“…Solid liver lesions accessible by EUS may be safely sampled by EUS-FNA. The use of stylet during FNA does not appear to confer any advantage with regards to the adequacy of specimen or diagnostic yield of malignancy [9] . In a prospective study of 132 subjects with newly diagnosed tumors, the diagnostic accuracy of EUS/ EUS-FNA and CT scan in detecting hepatic metastasis was 98% and 92%, respectively (P = 0.0578) [10] .…”

Section: Feasibility Of Endoscopic Ultrasound-guided Fine Needle Aspimentioning

confidence: 91%

Usefulness of endoscopic ultrasound-guided fine needle aspiration in the diagnosis of hepatic, gallbladder and biliary tract Lesions

Hammoud

Almashhrawi

Ibdah

2014

WJGO

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cholangiocarcinoma" and "EUS and gallbladder" to retrieve articles published between 1999 to 2014.Hammoud GM, Almashhrawi A, Ibdah JA. Usefulness of endoscopic ultrasound-guided fine needle aspiration in the diagnosis of hepatic, gallbladder and biliary tract Lesions. World J Gastrointest Oncol 2014; 6(11): 420-429 Available from: URL: http://www.wjgnet.com/1948-5204/full/v6/i11/420.htm DOI: http://dx.doi.org/10.4251/wjgo.v6.i11.420 INTRODUCTIONEndoscopic ultrasonography (EUS) has become an indispensable diagnostic and therapeutic procedure in the field of gastroenterology coupling endoscopy with high frequency echo sonography. Endoscopic ultrasoundguided fine needle aspiration (EUS-FNA) is performed using the curved linear array echoendoscope (Figure 1) using various needles (Figure 2). The recently introduced forward viewing linear echoendoscope is gaining momentum in endoscopic ultrasound-guided interventions (Figure 1). EUS-FNA is minimally invasive that is utilized for procurement of tissue from unresectable tumors. EUS-guided fine needle aspiration is used increasingly for the diagnosis of mediastinal, pancreatic and gastric tumors, however, not much is known about EUS-FNA in hepatic lesions. EUS imaging of the liver is currently limited to the left lobe, the proximal right lobe, the hilum and part of the intrahepatic biliary tract. EUS-FNA may be considered as an alternative to liver percutaneous biopsy in patients at high risk of bleeding or with small lesions of the liver uncharacterized by cross-sectional abdominal imaging. EUS-guided biliary drainage (EUS-BD) was developed using a curved linear array echoendoscope for cases with failed endoscopic biliary drainage. Table 1 AbstractEndoscopic ultrasound (EUS)-guided fine needle aspiration (FNA) of the liver is a safe procedure in the diagnosis and staging of hepatobiliary malignancies with a minimal major complication rate. EUS-FNA is useful for liver lesions poorly accessible to other imaging modalities of the liver. EUS-guided FNA of biliary neoplasia and malignant biliary stricture is superior to the conventional endoscopic brushing and biopsy.

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Section: Feasibility Of Endoscopic Ultrasound-guided Fine Needle Aspimentioning

confidence: 91%

Usefulness of endoscopic ultrasound-guided fine needle aspiration in the diagnosis of hepatic, gallbladder and biliary tract Lesions

Hammoud

Almashhrawi

Ibdah

2014

WJGO

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“…The yield for malignancy is similar with or without use of a stylet (87% vs 83%) [62][63][64], but in some studies sample adequacy was significantly better when a stylet was used (75% vs 87%) [62]. Also.…”

Section: Endoscopic Ultrasound Fine-needle Aspirationmentioning

confidence: 94%

“…Also. The amount of blood in the sample was greater when the stylet was used (75% vs 52%) [62][63][64]. Although no conclusion has yet been drawn, the ESGE recommendations leave it to the discretion of the endosonographer whetherto use a stylet or not [49].…”

Section: Endoscopic Ultrasound Fine-needle Aspirationmentioning

confidence: 99%

Endoscopic Ultrasound in Pancreatic Cancer: The New Perspective

Seicean¹

2014

Pancreatic Cancer - Insights Into Molecular Mechanisms and Novel Approaches to Early Detection and Treatment

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“…In an attempt to overcome these diagnostic limitations and optimize the accuracy, efficiency and quality of EUS-FNA specimens, various investigators have attempted to obtain tissue fragments with high negative pressure or with needles of varying diameters (18)(19)(20)(21) …”

Section: Introductionmentioning

confidence: 99%

“…Certain neoplasms, including lymphomas, stromal tumors and well-differentiated neoplasias are difficult to diagnose without histological samples, since tissue architecture and cell morphology are essential for accurate pathological assessments, which include immunohistochemical analyses in such cases (12)(13)(14). In addition, the accuracy of EUS-FNA depends on the presence of an on-site cytopathologist or cytotechnician to assess the specimen adequacy (15), and to determine whether additional samples are required to perform ancillary studies (16,17).In an attempt to overcome these diagnostic limitations and optimize the accuracy, efficiency and quality of EUS-FNA specimens, various investigators have attempted to obtain tissue fragments with high negative pressure or with needles of varying diameters (18)(19)(20)(21) …”

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confidence: 99%

Diagnostic accuracies of endoscopic ultrasound-guided fine-needle aspiration with distinct negative pressure suction techniques in solid lesions: A retrospective study

Wang

et al. 2017

Oncology Letters

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Abstract. Endoscopic ultrasound (EUS)-guided fine-needle aspiration (EUS-FNA) is highly accurate in obtaining specific diagnoses for various diseases. The present study aimed to evaluate the diagnostic yields, accuracies and sampling adequacies, of slow-pull, 5 ml suction and 10 ml suction techniques in EUS-FNA of solid lesions. The present study was a retrospective comparative study, which was performed in tertiary academic centers, recognized for their expertise in EUS and EUS-guided FNA. The present study involved 149 patients who underwent EUS-FNA of solid masses. A total of 34 (22.8%), 37 (24.8%) and 78 (52.4%) patients underwent EUS-FNA with slow-pull, 5 ml suction and 10 ml suction techniques, respectively. The EUS-FNA cytology and histology results were compared with those from the gold standard of surgical histopathology [hematoxylin-eosin staining; immunohistochemical test of cluster of differentiation (CD) 79a, CD20 and flow cytometry test] or long-term clinical follow-up. The present retrospective comparative study demonstrated that the diagnostic yields and accuracies of EUS-FNA with slow-pull (86.1%) were significantly superior to those achieved with 5 ml suction (83.3%) or 10 ml suction (69.9%; P<0.0001; χ 2 test). Consistently, 86.5% (32/37) of the samples obtained from the 5 ml suction group were adequate for histological diagnosis. By contrast, 70.6 (24/34) and 85.9% (67/78) of samples from the slow-pull and 10 ml suction groups were adequate for histological diagnosis, respectively. The samples obtained using 10 ml suction contained more blood compared with those obtained via slow-pull and 5 ml suction (P=0.0056; χ 2 test). No complications were noted in any of the three groups. The samples that were obtained for histopathological diagnosis using 5 ml suction were superior to those obtained using slow-pull or 10 ml suction. Additional multi-central prospective studies in which EUS-FNA is performed with variable negative pressures are required to improve the defining of the diagnostic roles of those techniques. IntroductionEndoscopic ultrasound (EUS)-guided fine-needle aspiration (EUS-FNA) has been reported to be a sensitive method for tissue sampling of suspicious lesions of the gastrointestinal lumen and adjacent structures, including pancreaticobiliary and esophageal lesions, gastric malignancies and mediastinal and intra-abdominal lymphadenopathies (1-6). The diagnostic accuracy of EUS-FNA ranges between 60 and 90%, according to the site being evaluated (1,7-11). Cytological study of the material obtained by FNA allows for the evaluation of cellular findings that are indicative of malignancy. However, EUS-FNA has a number of limitations. Certain neoplasms, including lymphomas, stromal tumors and well-differentiated neoplasias are difficult to diagnose without histological samples, since tissue architecture and cell morphology are essential for accurate pathological assessments, which include immunohistochemical analyses in such cases (12)(13)(14). In addition, the accuracy of EUS-FNA depend...

show abstract

A Comparative Study of Endoscopic Ultrasound Guided Fine Needle Aspiration With and Without a Stylet

Abstract: The use of stylet during FNA does not appear to confer any advantage with regards to the adequacy of specimen or diagnostic yield of malignancy.

Cited by 77 publications

References 29 publications

Usefulness of endoscopic ultrasound-guided fine needle aspiration in the diagnosis of hepatic, gallbladder and biliary tract Lesions

Usefulness of endoscopic ultrasound-guided fine needle aspiration in the diagnosis of hepatic, gallbladder and biliary tract Lesions

Endoscopic Ultrasound in Pancreatic Cancer: The New Perspective

Diagnostic accuracies of endoscopic ultrasound-guided fine-needle aspiration with distinct negative pressure suction techniques in solid lesions: A retrospective study

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