A novel endoscopic ultrasound-guided through-the-needle microbiopsy procedure improves diagnosis of pancreatic cystic lesions

Kovačević, Bojan; Klausen, Pia; Hasselby, Jane Preuss; Karstensen, John Gásdal; Rift, Charlotte Vestrup; Kalaitzakis, Evangelos; Toxværd, Anders; Hansen, Carsten P.; Storkholm, Jan Henrik; Hassan, Hazem; Vilmann, Peter

doi:10.1055/a-0625-6440

Cited by 38 publications

(52 citation statements)

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“…Endoscopic ultrasound‐guided (EUS) fine needle aspiration with assessment of cytological material has served as a cornerstone in the evaluation of these lesions, although the cytological material is often scarce. Recently, a novel through‐the‐needle microbiopsy forceps has been developed (Moray™; US Endoscopy, Mentor, OH, USA), which enables clinicians to obtain microbiopsies (MBs) from the cyst wall under EUS guidance, as described in a previous publication . Mutations in genes regulating cell cycle and repair appear to occur early in the natural history of mucinous cysts, and may serve as diagnostic markers for a pre‐operative estimate of malignant potential .…”

Section: Introductionmentioning

confidence: 99%

“…Recently, a novel through-the-needle microbiopsy forceps has been developed (Moray TM ; US Endoscopy, Mentor, OH, USA), which enables clinicians to obtain microbiopsies (MBs) from the cyst wall under EUS guidance, as described in a previous publication. 3 Mutations in genes regulating cell cycle and repair appear to occur early in the natural history of mucinous cysts, and may serve as diagnostic markers for a pre-operative estimate of malignant potential. 4 The aim of this study was to present our experience with next-generation sequencing (NGS) of MBs from pancreatic cysts.…”

Section: Introductionmentioning

confidence: 99%

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Next‐generation sequencing of endoscopic ultrasound guided microbiopsies from pancreatic cystic neoplasms

Rift¹,

Melchior²,

Kovačević

et al. 2019

Histopathology

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Aims Interpretation of cytology samples from pancreatic cysts is challenging. A novel microbiopsy forceps used during endoscopic ultrasound examinations offers new opportunities for histological examination of tissue from pancreatic cysts as well as next‐generation sequencing. The aim of this study was to analyse the results of next‐generation sequencing of microbiopsies from pancreatic cysts. Methods and results Microbiopsies from 27 patients were obtained, 23 of which were subjected to next‐generation sequencing. Sixteen intraductal papillary mucinous neoplasms harboured mutations in genes regulating cell cycle and repair, and three were without mutations. Most frequent mutations were found in the KRAS and GNAS genes, and these were often concomitant. Three serous cystic neoplasms were without mutations, while with regard to histology, a non‐diagnostic microbiopsy harboured a KRAS and a TP53 mutation and was deemed malignant after clinical follow‐up. Three patients underwent surgery, and the point mutations detected in the microbiopsies were confirmed in the resected specimens. We identified one resected sample with an additional GNAS mutation which was not identified in the microbiopsy. Conclusions Next‐generation sequencing of microbiopsies may have the potential to improve diagnostic decision‐making.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Next‐generation sequencing of endoscopic ultrasound guided microbiopsies from pancreatic cystic neoplasms

Rift¹,

Melchior²,

Kovačević

et al. 2019

Histopathology

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“…Charlotte Vestrup Rift 1 Anders Toxvaerd 2 Bojan Kovacevic 3 Pia Klausen 3 Carsten Palnaes Hansen 4 Peter Vilmann 3 Jane Preuss Hasselby 1…”

Section: Conflict Of Interestmentioning

confidence: 99%

Pitfalls of histopathological evaluation of EUS‐guided microbiopsies from pancreatic cystic neoplasms

et al. 2020

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“…Recently, several studies reported the utility of EUSthrough-the-needle biopsy (EUS-TTNB) for the diagnosis and risk stratification of the malignancy of pancreatic cystic lesions. [42][43][44][45][46] This novel technique enables direct sampling from the walls of pancreatic cystic lesions using biopsy microforceps through an EUS-FNA needle. One multicenter study enrolling 56 patients reported that technical success was 100% and the rate of adequate sampling for histological diagnosis was 83.9%.…”

Section: Endoscopic Ultrasound-through-the-needle Biopsymentioning

confidence: 99%

“…44 The rate of adverse events was 16.1%, but these were mild and were resolved by conservative therapy. Kovacevic et al 45 carried out EUS-TTNB in 31 consecutive patients with pancreatic cystic lesions and reported that clinical management was changed in six out of the 31 (19.4%) patients as a result of this evaluation. In some cases, the diagnosis could not be obtained using EUS-TTNB but could be obtained by cytology or cyst fluid evaluation; therefore, it may be important to diagnose using not just one but both of these methods together.…”

Section: Endoscopic Ultrasound-through-the-needle Biopsymentioning

confidence: 99%

Endoscopic diagnosis of cystic lesions of the pancreas

Kamata

Kitano

2018

Digestive Endoscopy

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Endoscopic methods are increasingly used in the diagnosis of cystic lesions of the pancreas. The two major endoscopic approaches are endoscopic ultrasonography (EUS) and transpapillary diagnosis. EUS-guided fine-needle aspiration cytology and EUS-guided fine needle-based confocal laser endomicroscopy have been used in the differential diagnosis of mucinous and non-mucinous pancreatic cysts. EUS is the most sensitive modality for detecting mural nodules (MN) in intraductal papillary mucinous neoplasms (IPMN). Contrast-enhanced harmonic EUS (CH-EUS), as an add-on to EUS, is useful for identifying and characterizing MN. Recent studies show that CH-EUS has a sensitivity of 60-100% and a specificity of 75-92.9% for diagnosing malignant cysts. Intraductal ultrasonography and peroral pancreatoscopy are especially useful for detecting MN and IPMN. A recent meta-analysis showed that cytological assessment of pancreatic juice using a transpapillary approach had a pooled sensitivity, specificity, and accuracy of 35.1%, 97.2%, and 92.9%, respectively, for diagnosing malignant IPMN. Further studies are warranted to determine the indications for each of these novel techniques in assessing cystic lesions of the pancreas.

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A novel endoscopic ultrasound-guided through-the-needle microbiopsy procedure improves diagnosis of pancreatic cystic lesions

Abstract: EUS-guided microbiopsy procedure was technically feasible, with a high diagnostic yield. Further prospective studies are needed to confirm these promising results.

Cited by 38 publications

References 10 publications

Next‐generation sequencing of endoscopic ultrasound guided microbiopsies from pancreatic cystic neoplasms

Next‐generation sequencing of endoscopic ultrasound guided microbiopsies from pancreatic cystic neoplasms

Pitfalls of histopathological evaluation of EUS‐guided microbiopsies from pancreatic cystic neoplasms

Endoscopic diagnosis of cystic lesions of the pancreas

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