Endoscopic ultrasound‐guided biopsies of pancreatic masses: Comparison between fine needle aspirations and needle core biopsies

Yun, Shine S.; Remotti, Helen; Vazquez, Madeline F.; Crapanzano, John P.; Saqi, Anjali

doi:10.1002/dc.20621

Cited by 28 publications

(15 citation statements)

References 25 publications

(57 reference statements)

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“…For CS, the relatively high unsatisfactory sample rate as compared to the corresponding rates in previous studies was probably due to the omission of on‐site cytology assessment; the cellularity and adequacy of specimens should be checked by a pathologist at the time of the procedure. On‐site assessment for adequacy of the FNA specimen has been emphasized in previous studies 21,22 . Moreover, we suggest that the split sample protocol brought about the high rate of unsatisfactory specimens for the LBC method.…”

Section: Discussionmentioning

confidence: 62%

“…In many studies, the false‐negative diagnosis of EUS‐FNA might be secondary to sampling and the nature of the neoplasm and rather than interpretation. Micrometastasis, intrinsic shortcomings of the biopsy apparatus, the location and size of the lesion, gauge of the needle, resolution of the probe, and the ability to visualize and guide the needle may have also contributed to false‐negative results 12,21,23 . No case of false‐negative result was caused by an interpretation error in our study.…”

Section: Discussionmentioning

confidence: 63%

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Utility of liquid‐based cytology in the evaluation of endoscopic ultrasound‐guided fine‐needle aspiration: Comparison with the conventional smears

Kim

Seo²,

Moon³

et al. 2010

Basic and Applied Pathology

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Background and aim: Recently, endoscopic ultrasound (EUS)‐guided fine‐needle aspiration (FNA) has been introduced in the diagnosis of pancreatic lesions, adjacent lymph nodes, and organs. To investigate the usefulness of liquid‐based cytology (LBC) in EUS‐FNA, we compare the efficacy of the conventional smear (CS) and LBC in EUS‐FNA specimens. Methods: Forty‐three paired LBC and CS slides were obtained using a split sample protocol. The specimen adequacy and diagnostic values were compared. Results: The adequate cases for diagnosis were 36 (83.7%) in CS and 22 (51.2%) in LBC. Inadequate samples were mostly obtained from lymph nodes: 6 cases in CS and 17 in LBC. The sensitivity, specificity, and accuracy of CS and LBC were as follows: 90.5%, 95.5%, and 93.0% in CS, respectively, and 57.1%, 100%, and 79.1% in LBC. The false‐negative and false‐positive rates were 4.7% and 2.3% in CS, respectively, and 20.9% and 0% in LBC. The overall agreement of CS and LBC for the diagnosis of malignancy was high (κ= 0.616). Conclusions: CS is a more effective and adequate preparation method for use in EUS‐FNA‐based diagnosis. Considering the split sample protocol of this study, LBC is a comparable diagnostic tool to CS in the evaluation of EUS‐FNA specimens.

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Section: Discussionmentioning

confidence: 62%

Section: Discussionmentioning

confidence: 63%

Utility of liquid‐based cytology in the evaluation of endoscopic ultrasound‐guided fine‐needle aspiration: Comparison with the conventional smears

Kim

Seo²,

Moon³

et al. 2010

Basic and Applied Pathology

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“…When performed transgastrically, the technique appears to be safe 96 . Recently, some authors have reported higher sensitivity for diagnosing pancreatic neoplasms for EUS-guided FNA compared with EUS-guided core biopsy 58,80,82 , but others have not 81 . The adequacy of sampling and diagnostic accuracy may be enhanced by combined EUS-guided FNA and EUS-guided trucut needle biopsy 58,81 .…”

Section: Endoscopic Ultrasound-guided Trucut Needle Biopsymentioning

confidence: 98%

“…A further seven studies on percutaneous 76 -79 or EUS-guided core biopsies 80 -82 of pancreatic masses met the inclusion criteria. Two studies evaluated EUS-guided FNA in combination with EUS-guided core biopsy 58,80 .…”

Section: Data Extractionmentioning

confidence: 99%

Preoperative tissue diagnosis for tumours of the pancreas

Hartwig

Schneider

Diener

et al. 2008

British Journal of Surgery

168

102

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“…1 Therefore, rapid and accurate assessment of a pancreatic mass is important to direct patient management. 2 …”

mentioning

confidence: 99%

Randomized trial comparing the 22-gauge aspiration and 22-gauge biopsy needles for EUS-guided sampling of solid pancreatic mass lesions

Bang

Hébert‐Magee

Trevino

et al. 2012

Gastrointestinal Endoscopy

255

280

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Background: To overcome limitations of cytology, biopsy needles have been developed to procure histologic samples during EUS. Objective: To compare 22-gauge (G) FNA and 22G biopsy needles (FNB) for EUS-guided sampling of solid pancreatic masses. Design: Randomized trial. Setting: Tertiary-care medical center. Patients: This study involved 56 patients with solid pancreatic masses. Intervention: Sampling of pancreatic masses by using 22G FNA or 22G FNB devices. Main Outcome Measurements: Compare the median number of passes required to establish the diagnosis, diagnostic sufficiency, technical performance, complication rates, procurement of the histologic core, and quality of the histologic specimen. Results: A total of 28 patients were randomized to the FNA group and 28 to the FNB group. There was no significant difference in median number of passes required to establish the diagnosis (1 [interquartile range 1-2.5] vs 1 [interquartile range 1-1]; P = .21), rates of diagnostic sufficiency (100% vs 89.3%; P = .24), technical failure (0 vs 3.6%; P = 1.0), or complications (3.6% for both) between FNA and FNB needles, respectively. Patients in whom diagnosis was established in passes 1, 2, and 3 were 64.3% versus 67.9%, 10.7% versus 17.9%, and 25% versus 3.6%, respectively, for FNA and FNB cohorts. There was no significant difference in procurement of the histologic core (100% vs 83.3%; P = .26) or the presence of diagnostic histologic specimens (66.7% vs 80%; P = .66) between FNA and FNB cohorts, respectively. Limitations: Only pancreatic masses were evaluated. Conclusion: Diagnostic sufficiency, technical performance, and safety profiles of FNA and FNB needles are comparable. There was no significant difference in yield or quality of the histologic core between the 2 needle types. (Clinical trial registration number: AQ:NCT01394159.) (Gastrointest Endosc 2012;76:321-7.)

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Endoscopic ultrasound‐guided biopsies of pancreatic masses: Comparison between fine needle aspirations and needle core biopsies

Cited by 28 publications

References 25 publications

Utility of liquid‐based cytology in the evaluation of endoscopic ultrasound‐guided fine‐needle aspiration: Comparison with the conventional smears

Utility of liquid‐based cytology in the evaluation of endoscopic ultrasound‐guided fine‐needle aspiration: Comparison with the conventional smears

Preoperative tissue diagnosis for tumours of the pancreas

Randomized trial comparing the 22-gauge aspiration and 22-gauge biopsy needles for EUS-guided sampling of solid pancreatic mass lesions

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