Diagnostic accuracy of EUS-guided fine-needle biopsy sampling by macroscopic on-site evaluation: a systematic review and meta-analysis

Mohan, Babu P.; Madhu, Deepak; Reddy, Nitin; Chara, Beatriz Sordi; Khan, Shahab R.; Garg, Gauri; Kassab, Lena L.; Muthusamy, Arun Kumar; Singh, Achintya D.; Chandan, Saurabh; Facciorusso, Antonio; Mangiavillano, Benedetto; Repici, Alessandro; Adler, Douglas G.

doi:10.1016/j.gie.2022.07.026

Cited by 23 publications

(17 citation statements)

References 26 publications

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“…Mohan et al conducted a meta‐analysis of the diagnostic outcome of EUS‐guided tissue acquisition with MOSE 5 . The pooled accuracy of FNA/B specimens in yielding a pathologic diagnosis by MOSE was 91.3% (95% CI: 88.6–93.3), with a pooled sensitivity of 91.5% (95% CI: 88.6–93.6), pooled specificity of 98.9% (95% CI: 96.6–99.7), pooled PPV of 98.8% (95% CI: 97.4–99.5), and pooled NPV of 55.5% (95% CI: 46.9–63.9).…”

Section: Discussionmentioning

confidence: 99%

Impact of macroscopic on‐site evaluation on the diagnostic outcomes of endoscopic ultrasound‐guided fine‐needle aspiration

Giri

Uppin

Kumar

et al. 2023

Diagnostic Cytopathology

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Background: Endoscopic ultrasound (EUS)-guided tissue acquisition is the preferred modality for diagnosing pancreatic lesions and mediastinal and abdominal lymph nodes. Rapid on-site cytologic evaluation improves the diagnostic outcome of EUS-guided fine-needle aspiration (FNA) but is unavailable at many centers.Alternatively, macroscopic on-site evaluation (MOSE) may improve the diagnostic outcome of EUS-FNA, but data are limited. Hence, the present study was conducted to assess the efficacy of MOSE in improving adequacy and accuracy.Methods: We retrospectively analyzed data of consecutive patients with pancreatic or lymph nodal lesions undergoing EUS-guided FNA at a tertiary care center from December 2020 to December 2022. The study's primary outcomes were adequacy and diagnostic accuracy of the EUS-guided tissue acquisition, with secondary analysis of predictors of adequacy and accuracy.Results: Data from 124 patients (44.4% male, median age: 54 years) who underwent EUS-FNA were included in the present analysis. The presence of macroscopic visible core (MVC) on MOSE was reported in 93/124 (75%) cases. An adequate sample for histopathological or cytological examination was obtained in 110/124 (88.7%) cases, while the diagnostic accuracy was 85.5%. On multivariate analysis, the absence of MVC on MOSE was found to be the independent negative predictor of both adequacy (OR 0.092, 95% CI: 0.024-0.349) and accuracy (OR 0.175, 95% CI: 0.057-0.536). Conclusion:The presence of MVC on MOSE can be an indicator of specimen adequacy and can improve the diagnostic yield of EUS-FNA.

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Section: Discussionmentioning

confidence: 99%

Impact of macroscopic on‐site evaluation on the diagnostic outcomes of endoscopic ultrasound‐guided fine‐needle aspiration

Giri

Uppin

Kumar

et al. 2023

Diagnostic Cytopathology

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“…No cytopathologist was present when the samples were collected, and no macroscopic on-site measurement was used in this study in order to maintain the comparison of one-to-one passes for each group [ 17 , 18 ]. The EUS-FNA and EUS-FNB visible cores were collected separately and inspected visually.…”

Section: Methodsmentioning

confidence: 99%

Endoscopic Ultrasound-Guided Fine-Needle Biopsy versus Fine-Needle Aspiration in the Diagnosis of Focal Liver Lesions: Prospective Head-to-Head Comparison

et al. 2022

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Endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) or fine-needle aspiration (EUS-FNA) from focal liver lesions are indicated in selected cases, but there has been no previous comparison of needle types of the same size. The aim of our study was to compare the histologic diagnostic accuracy and adequacy of cores obtained with EUS-FNB needles in contrast to those obtained with FNA needles in focal liver lesions. This prospective one-center study included patients with left lobe hepatic focal lesions with contraindications for percutaneous liver biopsy or need for EUS for concomitant lesions. Each patient had one pass of 22G EUS-FNB (Franseen) needle and one pass of 22G EUS-FNA in a crossover manner, without macroscopic on-site evaluation. Each sample was analyzed separately for histologic adequacy and diagnosis. The final diagnosis was based on histology results or on imaging follow-up in the case of negative biopsies. The EUS-FNB samples (n = 30) were found to be more adequate for histologic analysis, with more cellularity and longer tissue aggregates than the EUS-FNA samples (n = 30). The accuracy of EUS-FNB was 100%, whereas that of EUS-FNA was 86.7% (p = 0.039). No post-procedure complications were noted. The 22G EUS-FNB needle proved superior to 22G EUS-FNA in terms of tissue acquisition diagnostic accuracy and histologic adequacy in focal liver lesions.

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“…A meta-analysis examining the diagnostic parameters of EUS-guided tissue acquisition with MOSE included 14 studies with 1508 lesions in 1489 patients. 16 It revealed that the pooled accuracy of FNA and/or FNB specimens for achieving a pathologic diagnosis via MOSE was 91.3%, with a pooled sensitivity of 91.5% and a pooled specificity of 98.9%.Subgroup analyses utilizing newer-generation FNB needles, such as those with Franseen or Fork-tip shapes, demonstrated similar pooled rates of accuracy, sensitivity, and specificity at 90.6%, 91.5%, and 98.2%, respectively. The study determined that MOSE exhibited excellent diagnostic parameters for both EUS-FNA and FNB.…”

Section: Macroscopic On-site Evaluationmentioning

confidence: 99%

“…The utility of MOSE in EUS‐FNA has been established, and its effectiveness during EUS‐FNB has also been assessed recently. A meta‐analysis examining the diagnostic parameters of EUS‐guided tissue acquisition with MOSE included 14 studies with 1508 lesions in 1489 patients 16 . It revealed that the pooled accuracy of FNA and/or FNB specimens for achieving a pathologic diagnosis via MOSE was 91.3%, with a pooled sensitivity of 91.5% and a pooled specificity of 98.9%.…”

Section: Introductionmentioning

confidence: 99%

Advances and efficacy in specimen handling for endoscopic ultrasound‐guided fine needle aspiration and biopsy: A comprehensive review

Iwashita,

Uemura,

Ryuichi

et al. 2024

DEN Open

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Endoscopic ultrasound‐guided fine needle aspiration and biopsy have significantly evolved since they offer a minimally invasive approach for obtaining pathological specimens from lesions adjacent to or within the intestine. This paper reviews advancements in endoscopic ultrasound‐guided fine needle aspiration and biopsy techniques and devices, emphasizing the importance of handling specimens for diagnostic accuracy. Innovations of fine needle biopsy needles with features like side holes and Franseen shapes have enhanced histological sampling capabilities. Techniques for specimen handling, including rapid on‐site evaluation and macroscopic on‐site evaluation, play pivotal roles in assessing sample adequacy, thereby influencing diagnostic outcomes. The utility of artificial intelligence in augmenting rapid on‐site evaluation and macroscopic on‐site evaluation, although still in experimental stages, presents a promising avenue for improving procedural efficiency and diagnostic precision. The choice of specimen handling technique is dependent on various factors including endoscopist preference, procedure objectives, and available resources, underscoring the need for a comprehensive understanding of each method's characteristics to optimize diagnostic efficacy and procedural safety.

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Diagnostic accuracy of EUS-guided fine-needle biopsy sampling by macroscopic on-site evaluation: a systematic review and meta-analysis

Cited by 23 publications

References 26 publications

Impact of macroscopic on‐site evaluation on the diagnostic outcomes of endoscopic ultrasound‐guided fine‐needle aspiration

Impact of macroscopic on‐site evaluation on the diagnostic outcomes of endoscopic ultrasound‐guided fine‐needle aspiration

Endoscopic Ultrasound-Guided Fine-Needle Biopsy versus Fine-Needle Aspiration in the Diagnosis of Focal Liver Lesions: Prospective Head-to-Head Comparison

Advances and efficacy in specimen handling for endoscopic ultrasound‐guided fine needle aspiration and biopsy: A comprehensive review

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