Can the wet suction technique change the efficacy of endoscopic ultrasound-guided fine-needle aspiration for diagnosing autoimmune pancreatitis type 1? A prospective single-arm study

Sugimoto, Mitsuru; Takagi, Tadayuki; Suzuki, Rei; Konno, Naoki; Asama, Hiroyuki; Sato, Yuki; Irie, Hiroki; Watanabe, Ko; Nakamura, Jun; Kikuchi, Hitomi; Takasumi, Mika; Hashimoto, Minami; Kato, Tsunetaka; Hikichi, Takuto; Notohara, Kenji; Ohira, Hiromasa

doi:10.12998/wjcc.v8.i1.88

Cited by 13 publications

(20 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Finally, 15 studies 8 13 14 15 16 17 18 19 20 21 22 23 24 25 26 with 631 patients were included in the meta-analysis.…”

Section: Resultsmentioning

confidence: 99%

“…The recruitment period ranged from 1997 to 2018. Five studies 8 13 17 18 21 were prospective, of which one was a randomized-controlled trial (RCT) 8 , and ten were retrospective series 14 15 16 19 20 22 23 24 25 26 . Six studies tested 22G FNA needles 13 14 15 16 17 18 , one study the 19G FNA needle 19 , one study compared wet suction with either 19G and 22G FNA versus dry suction 21 , and another series did not specify the FNA device used 20 .…”

Section: Resultsmentioning

confidence: 99%

“…Five studies 8 13 17 18 21 were prospective, of which one was a randomized-controlled trial (RCT) 8 , and ten were retrospective series 14 15 16 19 20 22 23 24 25 26 . Six studies tested 22G FNA needles 13 14 15 16 17 18 , one study the 19G FNA needle 19 , one study compared wet suction with either 19G and 22G FNA versus dry suction 21 , and another series did not specify the FNA device used 20 . FNB was used in six studies 8 22 23 24 25 26 , of which one RCT 8 compared 22G Franseen FNB (Acquire) to 20G FNB needle (ProCore), one study compared 19G FNB to 22G reverse-bevel FNB needle (ProCore) 22 , one study tested the 21G FNB (Sonopsy CY) 23 , one study compared 19G TruCut (TCB) FNB to 22G FNA 26 , and two series merged data obtained with several devices 24 25 .…”

Section: Resultsmentioning

confidence: 99%

“…In 12 studies 8 13 15 16 17 18 19 21 23 24 25 26 the diagnosis achieved with EUS-TA was based on ICDC histologic criteria.…”

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Diagnostic yield of endoscopic ultrasound-guided tissue acquisition in autoimmune pancreatitis: a systematic review and meta-analysis

et al. 2021

View full text Add to dashboard Cite

Background and study aims There is limited evidence on the diagnostic performance of endoscopic ultrasound (EUS)-guided tissue acquisition in autoimmune pancreatitis (AIP). The aim of this meta-analysis was to provide a pooled estimate of the diagnostic performance of EUS-guided fine-needle aspiration (FNA) and fine-needle biopsy (FNB) in patients with AIP. Patients and methods Computerized bibliographic search was performed through January 2020. Pooled effects were calculated using a random-effects model by means of DerSimonian and Laird test. Primary endpoint was diagnostic accuracy compared to clinical diagnostic criteria. Additional outcomes were definitive histopathology, pooled rates of adequate material for histological diagnosis, sample adequacy, mean number of needle passes. Diagnostic sensitivity and safety data were also analyzed. Results Fifteen studies with 631 patients were included, of which four were prospective series and one randomized trial. Overall diagnostic accuracy of EUS tissue acquisition was 54.7 % (95 % confidence interval, 40.9 %–68.4 %), with a clear superiority of FNB over FNA (63 %, 52.7 % to 73.4 % versus 45.7 %, 26.5 %–65 %; p < 0.001). FNB provided level 1 of histological diagnosis in 44.2 % of cases (30.8 %–57.5 %) as compared to 21.9 % (10 %–33.7 %) with FNA (P < 0.001). The rate of definitive histopathology of EUS tissue sampling was 20.7 % (12.9 %–28.5 %) and it was significantly higher with FNB (24.3 %, 11.8 %–36.8 %) as compared to FNA (14.7 %, 5.4 %–23.9 %; P < 0.001). Less than 1 % of subjects experienced post-procedural acute pancreatitis. Conclusion The results of this meta-analysis demonstrate that the diagnostic performance of EUS-guided tissue acquisition is modest in patients with AIP, with an improved performance of FNB compared to FNA.

show abstract

“…Finally, 15 studies 8 13 14 15 16 17 18 19 20 21 22 23 24 25 26 with 631 patients were included in the meta-analysis.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…In 12 studies 8 13 15 16 17 18 19 21 23 24 25 26 the diagnosis achieved with EUS-TA was based on ICDC histologic criteria.…”

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Diagnostic yield of endoscopic ultrasound-guided tissue acquisition in autoimmune pancreatitis: a systematic review and meta-analysis

et al. 2021

View full text Add to dashboard Cite

show abstract

“…The wet technique involves flushing the needle with saline to replace the column of air within the lumen of the needle before needle aspiration, while a conventional EUS-FNA technique (so-called "dry suction technique; we defined this as "dry" technique in this article) applies negative pressure suction on an empty needle lumen after the stylet is removed. Several papers have reported on a wet EUS-FNA technique for various solid lesions such as mediastinal, pancreatic, nonpancreatic intra-abdominal, or pelvic cavity masses [7][8][9][10] and for liver biopsy [11,12] with improved tissue adequacy compared to the dry technique. However, no studies have reported on the use of the wet technique for UGI-SELs, for which it can be difficult to obtain specimens compared to lymph node and extraluminal masses.…”

Section: Introductionmentioning

confidence: 99%

A Pilot Randomized Crossover Trial of Wet Suction and Conventional Techniques of Endoscopic Ultrasound-Guided Fine-Needle Aspiration for Upper Gastrointestinal Subepithelial Lesions

Takasumi

Hikichi

Hashimoto

et al. 2021

Gastroenterology Research and Practice

Self Cite

View full text Add to dashboard Cite

Background and Aim. A wet suction technique (“wet” technique) has been developed to improve the quality of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) for sampling various solid lesions. However, no studies have reported on the wet technique for EUS-FNA for gastrointestinal (GI) subepithelial lesions (SELs). We conducted a pilot randomized crossover trial to explore whether the wet technique could be useful with regard to tissue adequacy of upper GI-SELs (UGI-SELs) compared to the conventional EUS-FNA technique (“dry” technique). Methods. Twenty-six patients with UGI-SELs indicated for EUS-FNA were randomly assigned to the dry-first arm using the dry technique for the first two passes or the wet-first arm using the wet technique for the first two passes using a cross-over design with a ratio of 1 : 1. The primary endpoint was the cellularity score of the EUS-FNA specimens rated on a 4-point scale (0-3). The secondary endpoints were the factors influencing cellularity in each suction technique. Results. The mean cellularity score was 1.65 ± 1.20 for the wet technique and 2.00 ± 0.98 for the dry technique ( p = 0.068 ). Logistic regression analysis showed that higher cellularity may be related to the final diagnosis of gastrointestinal stromal tumors in the dry technique and the SEL location in the upper stomach in the wet technique. Conclusion. The wet EUS-FNA technique failed to show a potential for improved cellularity of specimens compared to the dry technique for UGI-SELs.

show abstract

Biopsy diagnosis of type 1 autoimmune pancreatitis: Does it bring a conclusion or confusion?

Notohara

2021

DEN Open

Self Cite

View full text Add to dashboard Cite

A biopsy‐based diagnosis of type 1 autoimmune pancreatitis (AIP) is now feasible via an endoscopic ultrasound‐guided fine‐needle biopsy, but there are potential issues to address. The benefits of acquiring large tissue samples include more successful immunostaining for Immunoglobulin G4 and more identifications of storiform fibrosis, obliterative phlebitis, and the ductal lesions of type 1 AIP. However, storiform fibrosis may not be present in all the type 1 AIP lesions. An interobserver agreement study revealed only slight‐to‐moderate agreement among pathologists diagnosing the histological findings of type 1 AIP. Potential reasons for disagreement are the different time phases of the inflammation (which result in heterogeneous histological pictures), a focal appearance of the typical histological findings, and the different definitions used by pathologists. We have thus devised guidance for diagnosing type 1 AIP based on biopsy tissues. In this guidance, we define each histological finding of type 1 AIP, for example, storiform fibrosis as a swirling arrangement of inflammatory cells, spindle‐shaped cells, and delicate collagens as a unit. The necessity of elastic stains for identifying obliterative phlebitis is explained, with examples of mimickers. Another important purpose of a biopsy in type 1 AIP cases is differentiation from pancreatic ductal adenocarcinoma (PDAC). In this situation, acinar‐ductal metaplasia observed in type 1 AIP is a mimicker of PDAC and should not be confused. For the resolution of potential disagreements among pathologists, a multi‐disciplinary approach with the collaboration of clinicians, radiologists, and pathologists is necessary to avoid confusion.

show abstract

Can the wet suction technique change the efficacy of endoscopic ultrasound-guided fine-needle aspiration for diagnosing autoimmune pancreatitis type 1? A prospective single-arm study

Cited by 13 publications

References 20 publications

Diagnostic yield of endoscopic ultrasound-guided tissue acquisition in autoimmune pancreatitis: a systematic review and meta-analysis

Diagnostic yield of endoscopic ultrasound-guided tissue acquisition in autoimmune pancreatitis: a systematic review and meta-analysis

A Pilot Randomized Crossover Trial of Wet Suction and Conventional Techniques of Endoscopic Ultrasound-Guided Fine-Needle Aspiration for Upper Gastrointestinal Subepithelial Lesions

Biopsy diagnosis of type 1 autoimmune pancreatitis: Does it bring a conclusion or confusion?

Contact Info

Product

Resources

About