Diagnostic yield of malignancy during EUS-guided FNA of solid lesions with and without a stylet: a prospective, single blind, randomized, controlled trial

Wani, Sachin; Early, Dayna S.; Kunkel, Julie; Leathersich, Ann; Hovis, Christine E.; Hollander, Thomas; Kohlmeier, Cara; Zelenka, Cynthia; Azar, Riad R.; Edmundowicz, Steven A.; Collins, Brian T.; Liu, Jingxia; Hall, Matthew; Mullady, Daniel

doi:10.1016/j.gie.2012.03.1395

Cited by 87 publications

(72 citation statements)

References 33 publications

(40 reference statements)

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“…Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) biopsies were first reported by Vilmann et al in 1992 1 and have a high diagnostic accuracy (ranging from 70% to 98%) 2 . In most cases, a cytological assessment is sufficient for the diagnosis of a pancreatic tumor.…”

Section: Introductionmentioning

confidence: 99%

High and low negative pressure suction techniques in EUS-guided fine-needle tissue acquisition by using 25-gauge needles: a multicenter, prospective, randomized, controlled trial

Kudo

Kawakami

Hayashi

et al. 2014

Gastrointestinal Endoscopy

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Section: Introductionmentioning

confidence: 99%

High and low negative pressure suction techniques in EUS-guided fine-needle tissue acquisition by using 25-gauge needles: a multicenter, prospective, randomized, controlled trial

Kudo

Kawakami

Hayashi

et al. 2014

Gastrointestinal Endoscopy

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“…The yield for malignancy is similar with or without use of a stylet (87% vs 83%) [62][63][64], but in some studies sample adequacy was significantly better when a stylet was used (75% vs 87%) [62]. Also.…”

Section: Endoscopic Ultrasound Fine-needle Aspirationmentioning

confidence: 94%

“…Also. The amount of blood in the sample was greater when the stylet was used (75% vs 52%) [62][63][64]. Although no conclusion has yet been drawn, the ESGE recommendations leave it to the discretion of the endosonographer whetherto use a stylet or not [49].…”

Section: Endoscopic Ultrasound Fine-needle Aspirationmentioning

confidence: 99%

Endoscopic Ultrasound in Pancreatic Cancer: The New Perspective

Seicean¹

2014

Pancreatic Cancer - Insights Into Molecular Mechanisms and Novel Approaches to Early Detection and Treatment

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“…A recent prospective randomized, controlled trial was performed by Wani et al . [36] to evaluate the samples obtained by EUS-FNA with and without a stylet for solid subepithelial lesion. The samples were evaluated for diagnostic yield as well as cytopathology characteristics such as cellularity, degree of contamination and specimen adequacy.…”

Section: Use Of a Styletmentioning

confidence: 99%

When to puncture, when not to puncture: Submucosal tumors

Salah

Faigel

2014

Endosc Ultrasound

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Subepithelial masses of the gastrointestinal (GI) tract are a frequent source of referral for endosonographic evaluation. Subepithelial tumors most often appear as protuberances in the GI tract with normal overlying mucosa. When there is a need to obtain a sample of the mass for diagnosis, endoscopic ultrasound (EUS) - guided fine-needle aspiration (FNA) is superior to other studies and should be the first choice to investigate any subepithelial lesion. When the decision is made to perform EUS-guided FNA several technical factors must be considered. The type and size of the needle chosen can affect diagnostic accuracy, adequacy of sample size and number of passes needed. The use of a stylet or suction and a fanning or standard technique during EUS-guided FNA are other factors that must be considered. Another method proposed to improve the efficacy of EUS-guided FNA is having an on-site cytopathologist or cytotechnician. Large or well-differentiated tumors may be more difficult to diagnose by standard EUS-FNA and the use of a biopsy needle can be used to acquire a histopathology sample. This can allow preservation of tissue architecture and cellularity of the lesion and may lead to a more definitive diagnosis. Alternatives to FNA such as taking bite-on-bite samples and endoscopic submucosal resection (ESMR) have been studied. Comparison of these two techniques found that ESMR has a significantly higher diagnostic yield. Most complications associated with EUS-FNA such as perforation, infection and pancreatitis are rare and the severity and incidence of these adverse events is not known. Controversy exists as to the optimal method in which to perform EUS-FNA and larger prospective trials are needed.

show abstract

Diagnostic yield of malignancy during EUS-guided FNA of solid lesions with and without a stylet: a prospective, single blind, randomized, controlled trial

Cited by 87 publications

References 33 publications

High and low negative pressure suction techniques in EUS-guided fine-needle tissue acquisition by using 25-gauge needles: a multicenter, prospective, randomized, controlled trial

High and low negative pressure suction techniques in EUS-guided fine-needle tissue acquisition by using 25-gauge needles: a multicenter, prospective, randomized, controlled trial

Endoscopic Ultrasound in Pancreatic Cancer: The New Perspective

When to puncture, when not to puncture: Submucosal tumors

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