Drill needle aspiration biopsy for submucosal tumors in an experimental study

Uesato, Masaya; Tamachi, Tomohide; Hanari, Naoyuki; Muto, Yoshinori; Kagaya, Akiko; Urahama, Ryuma; Ogura, Yukiko; Suito, Hiroshi; Nakano, Akira; Aikawa, Masanori; Oide, Takashi; Matsubara, Hisahiro

doi:10.1007/s10120-016-0630-4

Cited by 5 publications

(4 citation statements)

References 20 publications

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“…Unfortunately, EUS-FNA for a subepithelial hypoechoic solid mass of < 1 cm is technically difficult using a standard EUS-FNA scope; thus, EUS-FNA is recommended for masses of > 1 cm[ 56 , 57 ]. However, forward-viewing and curved linear-array echoendoscopes [ 58 ] and drill needles[ 59 ] have recently been developed and are expected to improve the diagnostic rate of small SELs. The rate of adverse events associated with EUS-FNA using a 22-gauge needle is reportedly close to 0[ 54 - 56 ].…”

Section: Tumor Tissue Sampling Methodsmentioning

confidence: 99%

“…Invasive endoscopic tissue acquisition to obtain a higher tissue volume was recently developed and clinically applied[ 56 - 59 ]. Various endoscopic tissue-obtaining methods using endoscopic submucosal dissection (ESD) techniques or endoscopic snare resection techniques significantly increase the diagnostic yield when compared with standard forceps biopsy; the reported diagnostic rates range from 85% to 94%[ 61 - 64 ].…”

Section: Tumor Tissue Sampling Methodsmentioning

confidence: 99%

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Current clinical management of gastrointestinal stromal tumor

Akahoshi

Oya

Koga

et al. 2018

WJG

260

279

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Gastrointestinal stromal tumors (GISTs) are the most common malignant subepithelial lesions (SELs) of the gastrointestinal tract. They originate from the interstitial cells of Cajal located within the muscle layer and are characterized by over-expression of the tyrosine kinase receptor KIT. Pathologically, diagnosis of a GIST relies on morphology and immunohistochemistry [KIT and/or discovered on gastrointestinal stromal tumor 1 (DOG1) is generally positive]. The prognosis of this disease is associated with the tumor size and mitotic index. The standard treatment of a GIST without metastasis is surgical resection. A GIST with metastasis is usually only treated by tyrosine kinase inhibitors without radical cure; thus, early diagnosis is the only way to improve its prognosis. However, a GIST is usually detected as a SEL during endoscopy, and many benign and malignant conditions may manifest as SELs. Conventional endoscopic biopsy is difficult for tumors without ulceration. Most SELs have therefore been managed without a histological diagnosis. However, a favorable prognosis of a GIST is associated with early histological diagnosis and R0 resection. Endoscopic ultrasonography (EUS) and EUS-guided fine needle aspiration (EUS-FNA) are critical for an accurate diagnosis of SELs. EUS-FNA is safe and effective in enabling an early histological diagnosis and adequate treatment. This review outlines the current evidence for the diagnosis and management of GISTs, with an emphasis on early management of small SELs.

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Section: Tumor Tissue Sampling Methodsmentioning

confidence: 99%

Section: Tumor Tissue Sampling Methodsmentioning

confidence: 99%

Current clinical management of gastrointestinal stromal tumor

Akahoshi

Oya

Koga

et al. 2018

WJG

260

279

View full text Add to dashboard Cite

show abstract

“…Recently, Forward-viewing, curved linear-array, and drill needles are expected to improve the diagnostic rate for small SELs [56,68]. EUS-FNA using Forward-viewing EUS is safe and feasible for small SELs, and a method with a cap device and suction is more useful.…”

Section: Diagnostic Yield Of Eus-fna/bmentioning

confidence: 99%

The Diagnosis of Small Gastrointestinal Subepithelial Lesions by Endoscopic Ultrasound-Guided Fine Needle Aspiration and Biopsy

2022

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Endoscopic ultrasonography (EUS) has been widely accepted in the diagnosis of all types of tumors, especially pancreatic tumors, lymph nodes, and subepithelial lesions (SELs). One reason is that the examination can provide a detailed observation, with tissue samples being immediately obtained by endoscopic ultrasound-guided fine needle aspiration (EUS-FNA). Many SELs are detected incidentally during endoscopic examinations without symptoms. Most SELs are mesenchymal tumors originating from the fourth layer, such as gastrointestinal stromal tumors (GISTs), leiomyomas, and schwannomas. GISTs are potentially malignant. Surgical treatment is recommended for localized GISTs of ≥20 mm. However, the indications for the diagnosis and follow-up of GISTs of <20 mm in size are controversial. There are several reports on the rapid progression or metastasis of small GISTs. Therefore, it is important to determine whether a SEL is a GIST or not. The main diagnostic method is EUS-FNA. Recently, endoscopic ultrasound-guided fine needle biopsy (EUS-FNB) using a new biopsy needle has been reported to obtain larger tissue samples. Additionally, various biopsy methods have been reported to have a high diagnostic rate for small GISTs. In local gastric SELs, regardless of the tumor size, EUS can be performed first; then, EUS-FNA/B or various biopsy methods can be used to obtain tissue samples for decision-making in relation to therapy and the follow-up period.

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“…Massive studies have already been published regarding the diagnostic yield of EUS-FNAB. 22 - 56 A meta-analysis published in 2016 reports that EUS-guided sampling of upper gastrointestinal subepithelial lesions is safe, but has a moderate diagnostic ability (59.9%) regardless of techniques of FNA/FNB/Tru-Cut needle biopsy or the needle diameter used for puncture. 57 Conversely, a successive meta-analysis reveals that sampling ability of FNA (80.6%) is significantly lower to that of FNB (94.9%), but increase with the help of rapid on-site evaluation.…”

Section: Eus-guided Fine-needle Aspiration/biopsymentioning

confidence: 99%

Advancements in the Diagnosis of Gastric Subepithelial Tumors

2022

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A diagnosis of subepithelial tumors (SETs) is sometimes difficult due to the existence of overlying mucosa on the lesions, which hampers optical diagnosis by conventional endoscopy and tissue sampling with standard biopsy forceps. Imaging modalities, by using computed tomography and endoscopic ultrasonography (EUS) are mandatory to noninvasively collect the target's information and to opt candidates for further evaluation. Particularly, EUS is an indispensable diagnostic modality for assessing the lesions precisely and evaluating the possibility of malignancy. The diagnostic ability of EUS appears increased by the combined use of contrast-enhancement or elastography. Histology is the gold standard for obtaining the final diagnosis. Tissue sampling requires special techniques to break the mucosal barrier. Although EUS-guided fine-needle aspiration (EUS-FNA) is commonly applied, mucosal cutting biopsy and mucosal incision-assisted biopsy are comparable methods to definitively obtain tissues from the exposed surface of lesions and seem more useful than EUS-FNA for small SETs. Recent advancements in artificial intelligence (AI) have a potential to drastically change the diagnostic strategy for SETs. Development and establishment of noninvasive methods including AI-assisted diagnosis are expected to provide an alternative to invasive, histological diagnosis.

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Drill needle aspiration biopsy for submucosal tumors in an experimental study

Cited by 5 publications

References 20 publications

Current clinical management of gastrointestinal stromal tumor

Current clinical management of gastrointestinal stromal tumor

The Diagnosis of Small Gastrointestinal Subepithelial Lesions by Endoscopic Ultrasound-Guided Fine Needle Aspiration and Biopsy

Advancements in the Diagnosis of Gastric Subepithelial Tumors

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