Comparison between fine-needle biopsy and fine-needle aspiration for EUS-guided sampling of subepithelial lesions: a meta-analysis

Facciorusso, Antonio; Sunny, Sumsum; Prete, Valentina Del; Antonino, Matteo; Muscatiello, Nicola

doi:10.1016/j.gie.2019.07.018

Cited by 79 publications

(75 citation statements)

References 23 publications

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“…The diagnostic accuracy of EUSfine-needle biopsy is reportedly independent of the number of needle passes or the absence of ROSE [40,41]. Furthermore, EUS-fine-needle biopsy is known to outperform fine-needle aspiration in all diagnostic outcomes evaluated in subepithelial lesions [42]. However, a network meta-analysis showed that no specific EUS-guided tissue sampling technique was superior with regard to diagnostic accuracy, sample adequacy, or histologic procurement rate for solid pancreatic masses [43].…”

Section: Discussionmentioning

confidence: 99%

Diagnostic accuracy of endoscopic ultrasound-guided fine-needle aspiration: A single-center analysis

Ding¹,

Lu²,

Chen³

et al. 2020

Int. J. Med. Sci.

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Background: Endoscopic ultrasound-guided fine-needle aspiration biopsy (EUS-FNAB) has become an important modality for identification of intra-abdominal masses. This study analyzed the accuracy of EUS-FNAB in a single medical center and explored factors related to positive diagnosis. Materials and methods: In total, 77 patients with EUS-FNAB were retrospectively reviewed from July 2016 to February 2020. "Atypical (tends to be neoplasm/malignancy)," "suspicious (first consider neoplasm/malignancy)," and "malignant" were defined as positive cytology. The final diagnoses were based on histopathologic examination. The positive rate of EUS-FNAB for the diagnosis of neoplasm and its associations with age, sex, target puncture mass size, liver function, tumor markers, albumin, hypertension, and diabetes were examined. Results: Accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of EUS-FNAB cytologic diagnoses in all patients were 77.9% (60/77), 76.1% (54/71), 100%, 100%, and 26.1% (6/23), respectively. Accuracy, sensitivity, specificity, positive predictive value, and negative predictive value of EUS-FNAB cytologic diagnoses in the pancreas were 80.0% (48/60), 79.3% (46/58), 100%, 100%, and 14.3% (2/14), respectively. The results of EUS-FNAB in pancreatic masses showed that the level of CA19-9 was higher in the true positive group than in the false-negative group (p<0.05). There were no factors associated with the true positive cytologic diagnoses (p>0.05). Conclusions: Our single-medical center study showed that EUS-FNAB is an accurate diagnostic procedure for the evaluation of intra-abdominal masses. Further follow-up is required to explore factors associated with the true positive cytology.

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Section: Discussionmentioning

confidence: 99%

Diagnostic accuracy of endoscopic ultrasound-guided fine-needle aspiration: A single-center analysis

Ding¹,

Lu²,

Chen³

et al. 2020

Int. J. Med. Sci.

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“…In spite of the recent advancements in the field of EUS-guided tissue acquisition [ 29 ] of pancreatic masses, the relatively high rate of false negatives still represents an unsolved issue. The presence of fibrosis and necrosis inside the pancreatic mass is responsible for most of these false negative cases and requires frequently multiple FNA passes to achieve adequate samples.…”

Section: Discussionmentioning

confidence: 99%

Contrast-Enhanced Harmonic Endoscopic Ultrasound-Guided Fine-Needle Aspiration versus Standard Fine-Needle Aspiration in Pancreatic Masses: A Propensity Score Analysis

et al. 2020

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Background: Whether endoscopic ultrasound (EUS) contrast-enhanced fine-needle aspiration (CH-EUS-FNA) determines superior results in comparison to standard EUS-FNA in tissue acquisition of pancreatic masses remains unclear. The aim of this study was to compare these two techniques on a series of patients with solid pancreatic lesions. Methods: 362 patients underwent EUS-FNA (2008–2019), after the propensity score matching of two groups were compared; 103 treated with CH-EUS-FNA (group 1) and 103 with standard EUS-FNA (group 2). The primary outcome was the diagnostic accuracy. Secondary outcomes were sensitivity, specificity, and sample adequacy. Results: Diagnostic sensitivity was 87.6% in group 1 and 80% in group 2 (p = 0.18). The negative predictive value was 56% in group 1 and 41.5% in group 2 (p = 0.06). The specificity and positive predictive values were 100% for both groups. Diagnostic accuracy was 89.3% and 82.5%, respectively (p = 0.40). Sample adequacy was 94.1% in group 1 and 91.2% in group 2 (p = 0.42). The rate of adequate core histologic samples was 33% and 28.1%, respectively (p = 0.44), and the number of needle passes to obtain adequate samples were 2.4 ± 0.6 and 2.7 ± 0.8, respectively (p = 0.76). These findings were confirmed in subgroup analyses, conducted according to lesion size and contrast enhancement pattern. Conclusions: CH-EUS-FNA does not appear to be superior to standard EUS-FNA in patients with pancreatic masses.

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“…On the other hand, in the absence of ROSE, EUS-FNB had a relatively good diagnostic accuracy, suggesting that EUS-FNB is preferable when ROSE is not available. A meta-analysis revealed a significant difference in diagnostic yield between EUS-FNA and EUS-FNB in subepithelial lesions, but not in pancreatic lesions [30].…”

Section: (6) Eus-guided Fine-needle Biopsy (Eus-fnb)mentioning

confidence: 95%

Endoscopic Ultrasound-Guided Fine-Needle Aspiration (EUS-FNA) with Image Enhancement

2020

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Although endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is useful in the differential diagnosis of solid pancreatic lesions, lymph nodes, and liver lesions, inadequate sampling may result in an incorrect pathological diagnosis. The accuracy of EUS for the evaluation of pancreatobiliary lesions may be increased by image enhancement technologies, including contrast-enhanced harmonic (CH)-EUS and EUS-elastography. These methods can provide information that complement EUS-FNA for the diagnosis and staging of pancreatobiliary cancer, and can help to identify the EUS-FNA target, reducing the requirement for repeat FNA.

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Comparison between fine-needle biopsy and fine-needle aspiration for EUS-guided sampling of subepithelial lesions: a meta-analysis

Cited by 79 publications

References 23 publications

Diagnostic accuracy of endoscopic ultrasound-guided fine-needle aspiration: A single-center analysis

Diagnostic accuracy of endoscopic ultrasound-guided fine-needle aspiration: A single-center analysis

Contrast-Enhanced Harmonic Endoscopic Ultrasound-Guided Fine-Needle Aspiration versus Standard Fine-Needle Aspiration in Pancreatic Masses: A Propensity Score Analysis

Endoscopic Ultrasound-Guided Fine-Needle Aspiration (EUS-FNA) with Image Enhancement

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