Comparison of EUS-Guided 19-Gauge Trucut Needle Biopsy With EUS-Guided Fine-Needle Aspiration

Holt, Bronte A.; Fraig, Mostafa; Schmulewitz, Nathan; Roberts, Samuel T.; Wildi, Stephan M.; Hawes, Robert H.; Bj, Hoffman; Wallace, Michael B.

doi:10.1055/s-2004-814316

Cited by 236 publications

(178 citation statements)

References 5 publications

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“…168 Another publication reported a lower accuracy of EUS-CNB compared with EUS-FNA, although the difference was not statistically significant. 169 A few studies have focused on EUS-CNB of solid pancreatic masses. EUS-CNB was feasible through the transgastric route, while the transduodenal approach was successful in only 40% of cases.…”

Section: Eus-cnbmentioning

confidence: 99%

Role of endoscopic ultrasound in the diagnosis and staging of pancreatic cancer

Săftoiu

Vilmann

2008

J of Clinical Ultrasound

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Early diagnosis of pancreatic cancer remains a difficult task, and multiple imaging tests have been proposed over the years. The aim of this review is to describe the current role of endoscopic ultrasound (EUS) for the diagnosis and staging of patients with pancreatic cancer. A detailed search of MEDLINE between 1980 and 2007 was performed using the following keywords: pancreatic cancer, endoscopic ultrasound, diagnosis, and staging. References of the selected articles were also browsed and consulted. Despite progress made with other imaging methods, EUS is still considered to be superior for the detection of clinically suspected lesions, especially if the results of other cross-sectional imaging modalities are equivocal. The major advantage of EUS is the high negative predictive value that approaches 100%, indicating that the absence of a focal mass reliably excludes pancreatic cancer. The introduction of EUS-guided fine needle aspiration allows a preoperative diagnosis in patients with resectable cancer, as well as a confirmation of diagnosis before chemoradiotherapy for those that are not. This comprehensive review highlighted the diagnostic capabilities of EUS including the newest refinements such as contrast-enhanced EUS, EUS elastography, and 3-dimensional EUS. The place of EUSguided biopsy is also emphasized, including the addition of molecular marker techniques.

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Section: Eus-cnbmentioning

confidence: 99%

Role of endoscopic ultrasound in the diagnosis and staging of pancreatic cancer

Săftoiu

Vilmann

2008

J of Clinical Ultrasound

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“…Impact of endoscopic ultrasound-guided fine needle biopsy for diagnosis of pancreatic masses needles of different diameters and trucut needles have been used with variable success and complication rates [7][8][9][10][11] . The aim of the present study was to evaluate the diagnostic accuracy of the histological evaluation of pancreatic tissue samples obtained by a modified method for recovering and processing the EUS-guided FNA material in the differential diagnosis of pancreatic solid masses.…”

Section: Rapid Communicationmentioning

confidence: 99%

Impact of endoscopic ultrasound-guided fine needle biopsy for diagnosis of pancreatic masses

Iglesias‐García

Domínguez‐Muñoz²,

Lozano-León³

et al. 2007

WJG

112

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INTRODUCTIONDifferential diagnosis of pancreatic masses is a frequent clinical challenge. Therapeutic decision in this context is mainly based on the ability to establish or exclude malignancy [1] . Although ductal adenocarcinoma is the most frequent cause of pancreatic masses, other neoplasms (e.g. lymphoma, cystic tumours) and benign conditions (e.g. chronic pancreatitis) with different prognoses and treatment options can arise within the pancreas. A histological diagnosis becomes therefore highly relevant for an optimal therapeutic decision [2] . Endoscopic ultrasound (EUS)-guided fine needle aspiration (FNA) has been proved to be a safe and useful method for tissue sampling of intramural and extramural gastrointestinal lesions including the pancreas [3,4] . Cytological study of the materials obtained by FNA allows the evaluation of cellular findings suggestive of malignancy, such as anisonucleosis, nuclear membrane irregularity and nuclear enlargement. Unfortunately, inflammation causes a reactive and regenerative process leading to cellular changes that can be difficult to distinguish from well-differentiated neoplasias. Histological study of tissue samples allows the assessment of tissue architecture and cell morphology, as well as the performance of immunohistochemical analysis [5,6] , thus usually providing with a higher diagnostic accuracy than cytology.Retrieving Abstract AIM: To evaluate the diagnostic accuracy of histological evaluation of pancreatic tissue samples obtained by a modified method for recovering and processing the endoscopic ultrasound (EUS)-guided fine needle aspiration (FNA) material in the differential diagnosis of pancreatic solid masses. METHODS:Sixty-two consecutive patients with pancreatic masses were prospectively studied. EUS was performed by the linear scanning Pentax FG-38UX echoendoscope. Three FNAs (22G needle) were carried out during each procedure. The materials obtained with first and second punctures were processed for cytological study. Materials of the third puncture were recovered into 10% formol solution by careful injection of saline solution through the needle, and processed for histological study. RESULTS:Length of the core specimen obtained for histological analysis was 6.5 ± 5.3 mm (range 1-22 mm). Cytological and histological samples were considered as adequate in 51 (82.3%) and 52 cases (83.9%), respectively. Overall sensitivity of both pancreatic cytology and histology for diagnosis of malignancy was 68.4%. Contrary to cytology, histology was able to diagnose tumours other than adenocarcinomas, and all cases of inflammatory masses. Combination of cytology and histology allowed obtaining an adequate sample in 56 cases (90.3%), with a global sensitivity of 84.21%, specificity of 100% and an overall accuracy of 90.32%. The complication rate was 1.6%. CONCLUSION:Adequate pancreatic core specimens for

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“…However, there are certain drawbacks with this needle restricting its use in clinical practice. Most importantly, its diagnostic yield is strongly limited for lesions located in the head of the pancreas due to mechanical friction of the needle firing mechanism ensuing from the bended scope position (35)(36)(37)(38). Nowadays a new 19-gauge fine needle biopsy needle (ProCore TM , Cook Endoscopy Inc., Limerick, Ireland) device has been designed.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the adequacy and diagnostic accuracy of the histology samples obtained with a newly designed 19-gauge EUS histology needle

Iglesias‐García

Abdulkader

Lariño‐Noia

et al. 2014

Rev. esp. enferm. dig.

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Background: Endoscopic ultrasound (EUS)-guided fine needle aspiration (FNA) is an accurate technique for sampling intraintestinal and extraintestinal lesions. However, cytology possesses certain limitations, which may be overcome if histological specimens are provided to the pathologist.Aim: The aim of the study was to evaluate the accuracy of a newly developed 19G histology needle.Methods: Retrospective analysis of a prospectively collected data base including patients who underwent EUS-guided biopsy with the 19G ProCore TM histology needle for the evaluation of intraintestinal or extraintestinal lesions. Samples were obtained after one needle pass, recovered into ThinPrep ® and processed for histological analysis. Results were compared to the gold standard of surgical histopathology, or global pathological, clinical and radiological assessment, and follow-up in non-operated cases. Results are shown as mean ± SD. Percentage of optimal samples for histological evaluation and the overall diagnostic accuracy were evaluated.Results: 87 patients (mean age 62.9 years, range 25-88 years, 36 woman) were included. Lesions mean size was 41.6 ± 21.3 mm. 66 lesions (75.9 %) were considered as malignant and 21 (24.1 %) as benign. EUS-guided biopsy was feasible in all cases (100 %). Sample quality was adequate for histological assessment in 82 lesions (94.2 %). In the remaining cases the sample was adequate for cell-block evaluation. Sensitivity, specificity, PPV, NPV, and overall accuracy for malignancy were 93.4 %, 100 %, 100 %, 84 %, and 95.4 %, respectively. There were no complications related to the procedure. Conclusion:The EUS-guided biopsy with the 19G histology needle provides with an optimal core sample for histological evaluation allowing a high histopathologic diagnostic accuracy.

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Comparison of EUS-Guided 19-Gauge Trucut Needle Biopsy With EUS-Guided Fine-Needle Aspiration

Abstract: The diagnostic accuracy of the new EUS-TNB is comparable to that of EUS-FNA. In our experience, the overall efficacy and safety profile of the Trucut needle appears modest.

Cited by 236 publications

References 5 publications

Role of endoscopic ultrasound in the diagnosis and staging of pancreatic cancer

Role of endoscopic ultrasound in the diagnosis and staging of pancreatic cancer

Impact of endoscopic ultrasound-guided fine needle biopsy for diagnosis of pancreatic masses

Evaluation of the adequacy and diagnostic accuracy of the histology samples obtained with a newly designed 19-gauge EUS histology needle

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