Comparative diagnostic performance of different techniques for EUS-guided fine-needle biopsy sampling of solid pancreatic masses: a network meta-analysis

Facciorusso, Antonio; Crinò, Stefano Francesco; Ramai, Daryl; Madhu, Deepak; Fugazza, Alessandro; Carrara, Sandro; Spadaccini, Marco; Mangiavillano, Benedetto; Gkolfakis, Paraskevas; Mohan, Babu P.; Hassan, Cesare; Repici, Alessandro

doi:10.1016/j.gie.2023.01.024

Cited by 28 publications

(29 citation statements)

References 34 publications

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“…Recently, a network meta-analysis showed that FNB needles (Franseen and Forktip needles) are significantly superior to reverse bevel and FNA needles [ 33 ]. Furthermore, regarding tissue collection methods in EUS-FNB, Facciorusso et al compared the “slow-pull”, “dry suction”, “modified wet suction” (with the needle preflushed with 1–2 mL of saline after removing the stylet, application of suction using a 10 mL pre-vacuum syringe), and “no suction” techniques in a network meta-analysis [ 34 ]. They reported that the “wet suction” technique yields the most adequate samples.…”

Section: Discussionmentioning

confidence: 99%

Next-Generation Sequencing Analysis of Pancreatic Cancer Using Residual Liquid Cytology Specimens from Endoscopic Ultrasound—Guided Fine-Needle Biopsy: A Prospective Comparative Study with Tissue Specimens

et al. 2023

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This study evaluated the feasibility and clinical utility of liquid-based cytology (LBC) specimens via endoscopic ultrasound–guided fine-needle biopsy (EUS-FNB) for next-generation sequencing (NGS) of pancreatic cancer (PC). We prospectively evaluated the performance of DNA extraction and NGS using EUS-FNB samples obtained from PC. Thirty-three consecutive patients with PC who underwent EUS-FNB at our hospital were enrolled. DNA samples were obtained from 96.8% of the patients. When stratified with a variant allele frequency (VAF) > 10% tumor burden, the NGS success rate was 76.7% (n = 23) in formalin-fixed paraffin-embedded (FFPE), 83.3% (n = 25) in LBC, and 76.7% (n = 23) in frozen samples. The overall NGS success rate was 86.7% (n = 26) using FFPE, LBC, or frozen samples. The detection rates for the main mutated genes were as follows: 86.7% for KRAS, 73.3% for TP53, 66.7% for CDKN2A, 36.7% for SMAD4, and 16.7% for ARID1A. LBC had the highest median value of VAF (23.5%) for KRAS and TP53. PC mutation analysis using NGS was successfully performed using LBC compared with FFPE and frozen samples. This approach provides an alternative and affordable source of molecular testing materials.

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Section: Discussionmentioning

confidence: 99%

Next-Generation Sequencing Analysis of Pancreatic Cancer Using Residual Liquid Cytology Specimens from Endoscopic Ultrasound—Guided Fine-Needle Biopsy: A Prospective Comparative Study with Tissue Specimens

et al. 2023

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“…Therefore, it is possible that a larger number of patients who underwent EUS-FNB underwent biliary drainage using SEMSs due to evidence demonstrating their superiority over plastic stents [ 26 ]. In other words, both EUS-FNB and SEMSs have become widespread during recent decades [ 27 , 28 , 29 , 30 ], and it is possible that the negative impact of biliary stents was related to the more frequent use of SEMSs rather than plastic stents.…”

Section: Discussionmentioning

confidence: 99%

Do Biliary Stents Affect EUS-Guided Tissue Acquisition (EUS-TA) in Solid Pancreatic Lesions Determining Biliary Obstruction? A Literature Review with Meta-Analysis

Facciorusso

Chandan

Gkolfakis

et al. 2023

Cancers

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There is a paucity of evidence regarding whether biliary stents influence endoscopic ultrasound-guided tissue acquisition using either fine-needle biopsy (EUS-FNB) or fine-needle aspiration (EUS-FNA), among patients with head of pancreas (HOP) lesions. We aimed at assessing the diagnostic accuracy of endoscopic ultrasound-guided tissue sampling in patients with or without bile duct stents. A total of seven studies with 2458 patients were included. The main aim was to assess overall pooled diagnostic accuracy. A pairwise meta-analysis was performed using a random effects model. Outcomes were expressed as odds ratios (ORs) with 95% confidence intervals (CIs). We found that pooled accuracy was 85.4% (CI 78.8–91.9) and 88.1% (CI 83.3–92.9) in patients with and without stents, respectively. There was no statistically significant difference between the two (OR 0.74; p = 0.07). Furthermore, patients with metal stents demonstrated a significant difference (OR 0.54, 0.17–0.97; p = 0.05), which was not seen with plastic stents. EUS-FNB showed poorer diagnostic accuracy with concurrent biliary stenting (OR 0.64, 0.43–0.95; p = 0.03); however, the same was not observed with EUS-FNA. Compared to plastic stents, metal biliary stenting further impacted the diagnostic accuracy of EUS-guided tissue acquisition for pancreatic head lesions. There was no difference in the rate of procedure-related adverse events between the stent and no-stent groups.

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“…Over the years, the indications for the use of EUS beyond the pancreas have expanded. EUS can provide diagnostic assistance in organs and structures near the GI tract [ 90 , 91 ] ( Table 1 ) and it can also be useful in interventional procedures [ 92 - 95 ]. Using high-resolution imaging of adjacent organs, even small lesions can be sampled in a safe and controlled manner, thus eliminating the need for more invasive methods such as surgery.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic ultrasound-guided tissue acquisition beyond the pancreas

Manthopoulou

Ramai

Ioannou³

et al. 2023

aog

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Comparative diagnostic performance of different techniques for EUS-guided fine-needle biopsy sampling of solid pancreatic masses: a network meta-analysis

Cited by 28 publications

References 34 publications

Next-Generation Sequencing Analysis of Pancreatic Cancer Using Residual Liquid Cytology Specimens from Endoscopic Ultrasound—Guided Fine-Needle Biopsy: A Prospective Comparative Study with Tissue Specimens

Next-Generation Sequencing Analysis of Pancreatic Cancer Using Residual Liquid Cytology Specimens from Endoscopic Ultrasound—Guided Fine-Needle Biopsy: A Prospective Comparative Study with Tissue Specimens

Do Biliary Stents Affect EUS-Guided Tissue Acquisition (EUS-TA) in Solid Pancreatic Lesions Determining Biliary Obstruction? A Literature Review with Meta-Analysis

Endoscopic ultrasound-guided tissue acquisition beyond the pancreas

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