Efficacy of 3 fine-needle biopsy techniques for suspected pancreatic malignancies in the absence of an on-site cytopathologist

Lee, Ka Young; Cho, Hyun Deuk; Hwangbo, Young; Yang, Jae Kook; Han, Su Jung; Choi, Hyun Jong; Lee, Yun Nah; Cha, Sang‐Woo; Cho, Young Deok; Park, Sang‐Heum; Lee, Tae Hoon

doi:10.1016/j.gie.2018.10.042

Cited by 36 publications

(64 citation statements)

References 22 publications

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“…▶ Table 1 summarizes the characteristics of the seven included studies [10,11,[17][18][19][20][21]. They were all full-text RCTs published between 2017 and 2019; two were initially available only as abstracts from conferences' proceedings at the time of submission that during the revision process became available as full text and whose data were accordingly updated [20,21].…”

Section: Search Results and Study Characteristicsmentioning

confidence: 99%

“…Only two studies [10,20] were multicentric. Two studies were carried out in the US [10,11], 2 in Korea [18,19] and one each in Brazil [21], India [17] and Italy [20]. Different needles were employed, with 3 studies employing FNB needles [11,19,20] and 4 FNA [10,17,18,21]).…”

Section: Search Results and Study Characteristicsmentioning

confidence: 99%

“…Two studies were carried out in the US [10,11], 2 in Korea [18,19] and one each in Brazil [21], India [17] and Italy [20]. Different needles were employed, with 3 studies employing FNB needles [11,19,20] and 4 FNA [10,17,18,21]). Four of the studies randomized distinct individual patients with solid pancreatic lesions to either SU or SP sampling [10,11,17,20], for a total of 327 patients (164 SP, 163 SU); the remaining 3 studies [18,19,21] randomized the same patients with solid pancreatic lesions to both SU and SP sampling in a random order, for a total of 148 patients.…”

Section: Search Results and Study Characteristicsmentioning

confidence: 99%

“…Four of the seven studies [11,[17][18][19] reported data on the diagnostic adequacy comparing SU and SP. Samples were considered adequate in case of "cytological aspirates or histological core tissue samples that were sufficient for diagnostic interpretation" [11], or if "adequate for the cytopathologist to make a diagnosis" [17], or if "sufficient amount of representative cells for pathological diagnosis" [18] was provided, while the definition was not clearly provided in one study [19]. There was no significant difference between the two techniques (▶ Fig.…”

Section: Diagnostic Adequacymentioning

confidence: 99%

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Slow-pull compared to suction technique for EUS-guided sampling of pancreatic solid lesions: a meta-analysis of randomized controlled trials

2020

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Background and study aims Current ESGE guidelines suggest employing the suction (SU) technique for endoscopic ultrasound (EUS)-guided sampling of pancreatic solid lesions. Nonetheless, recent randomized controlled trials (RCT) have reported that the slow-pull (SP) technique has similar diagnostic accuracy with possibly less blood contamination. However, these results are heterogeneous and limited to small cohorts. The aim of this meta-analysis was to compare adequacy, accuracy, sensitivity and specificity of the SU and SP techniques for EUS-guided sampling of solid pancreatic lesions. Methods A computerized bibliographic search was restricted to RCTs. Pooled effects were calculated using a random-effects model and expressed in terms of pooled sensitivity and specificity and OR (95 % CI) for adequacy and accuracy. Results Overall, seven RCTs were included, for a total of 475 patients (163 lesions sampled with SU, 164 with SP and 148 by both). The adequacy was similar (OR = 0.98) without heterogeneity (I2 = 0 %), but a high degree of blood contamination was more common with SU than SP (pooled rate 27.6 % vs 19.7 %). A non-significant superiority of SP in terms of pooled accuracy (OR = 0.82; 95 % CI 0.36–1.85) was recorded, with moderate heterogeneity (I2 = 52.4 %). The SP technique showed a slightly higher pooled sensitivity compared to SU (88.7 % vs 83.4 %), while specificity was similar (97.2 % SP vs 96.9 % SU), with considerable heterogeneity. Conclusion The current meta-analysis reveals non-superiority of SU over SP, while SP results in reduced blood contamination. If the 5 % accuracy difference favouring SP is true, with alfa error = 0.05 and beta = 0.20, a RCT of 982 patients per arm is needed to confirm significance.

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Section: Search Results and Study Characteristicsmentioning

confidence: 99%

Section: Search Results and Study Characteristicsmentioning

confidence: 99%

Section: Search Results and Study Characteristicsmentioning

confidence: 99%

Section: Diagnostic Adequacymentioning

confidence: 99%

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Slow-pull compared to suction technique for EUS-guided sampling of pancreatic solid lesions: a meta-analysis of randomized controlled trials

2020

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“…Use of the SSP technique and tumor size > 40 mm were favorable factors for diagnostic adequacy [37].…”

Section: Techniques For Specimen Acquisitionmentioning

confidence: 98%

Tissue acquisition and pancreatic masses: Which needle and which acquisition technique should be used?

et al. 2020

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Background and study aims Pancreatic cancer represents the fourth most common cause of cancer-related deaths in Western countries and the need of a low-risk investigation to obtain an accurate histopathological diagnosis has become increasingly pressing. Endoscopic ultrasonography (EUS) with fine-needle aspiration (FNA) is the standard method for obtaining samples from pancreatic masses. In recent years, there has been an increasing need to obtain histological specimens during EUS procedures, rather than cytological ones, to guide oncological treatment options, leading to the so-call “FNB concept.” Different needles have been developed for fine-needle biopsy (FNB) in recent years, enabling acquisition of larger specimens on which to perform histological and molecular analyses. The aim of this narrative review was to assess the role of EUS-guided FNA and FNB in patients with pancreatic masses, and to identify which needle and which acquisition technique should be used to improve tissue acquisition.

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A prospective study on the histological evaluation of type 1 autoimmune pancreatitis using endoscopic ultrasound‐guided fine needle biopsy with a 19‐gauge Franseen needle

Ishikawa,

Yamao,

Mizutani

et al. 2024

J Hepato Biliary Pancreat

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Background/PurposeTo assess the diagnostic efficacy and safety of endoscopic ultrasound‐guided fine needle biopsy (EUS‐FNB) using a 19‐gauge Franseen needle for autoimmune pancreatitis (AIP).MethodsTwenty patients suspected of having type 1 AIP were prospectively enrolled and underwent EUS‐FNB with a 19‐gauge Franseen needle. Their data were compared with those of historical controls: a total of 29 type 1 AIP patients had EUS‐FNB with a 22‐gauge Franseen needle.ResultsSpecimens suitable for histological evaluation were obtained from 19 of the 20 patients (95%), and the median total tissue area was 11.9 mm2. The histological diagnosis rate of AIP was 65% (95% CI: 43.2%–82%). Adverse events were observed in three patients (15%), and a switch to 22‐gauge needles occurred during transduodenal puncture in two patients. Compared to those punctured with 22‐gauge needles, patients punctured with 19‐gauge needles had greater prevalence of each characteristic feature of lymphoplasmacytic sclerosing pancreatitis, but the difference was not statistically significant.ConclusionsEUS‐FNB using a 19‐gauge Franseen needle demonstrated favorable performance for the histological diagnosis of AIP and allowed for large tissue samples, potentially facilitating pathological diagnosis. However, during transduodenal puncture, maneuverability is reduced; therefore, the needle may need to be selected according to the puncture site.

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Efficacy of 3 fine-needle biopsy techniques for suspected pancreatic malignancies in the absence of an on-site cytopathologist

Cited by 36 publications

References 22 publications

Slow-pull compared to suction technique for EUS-guided sampling of pancreatic solid lesions: a meta-analysis of randomized controlled trials

Slow-pull compared to suction technique for EUS-guided sampling of pancreatic solid lesions: a meta-analysis of randomized controlled trials

Tissue acquisition and pancreatic masses: Which needle and which acquisition technique should be used?

A prospective study on the histological evaluation of type 1 autoimmune pancreatitis using endoscopic ultrasound‐guided fine needle biopsy with a 19‐gauge Franseen needle

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