Endoscopic ultrasound guided fine‐needle aspiration: What variables influence diagnostic yield?

Mohanty, Sambit K.; Pradhan, Dinesh; Sharma, Shivani; Sharma, Anurag; Patnaik, Niharika; Feuerman, Martin; Bonasara, Robert; Boyd, Adrienne; Friedel, David; Stavropoulos, Stavros N.; Gupta, Mala

doi:10.1002/dc.23883

Cited by 17 publications

(5 citation statements)

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“…The level of experience of the endoscopist was also ascertained as a factor affecting the adequacy of samples obtained. Some studies attributed false-negative diagnoses to the technical difficulty in obtaining a sufficient tissue volume [13,14], which means that obtaining sufficient experience is key to achieving a good diagnostic yield [15]. In our study, a stable diagnostic yield (> 80%) was achieved after performing > 40 procedures-a finding that was compatible with previously reported learning data [16][17][18].…”

Section: Discussionsupporting

confidence: 90%

Factors affecting cytological results of endoscopic ultrasound guided-fine needle aspiration during learning

Lai

Lin

2020

Diagn Pathol

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Background: Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is a standard procedure used to obtain tissue samples for diagnosis of solid retroperitoneal tumours. However, this procedure demands high technical expertise and requires a strong learning curve. Our aim was to identify factors associated with falsenegative EUS-FNA results during the learning for endoscopists.Methods: Our retrospective analysis was based on the EUS-FNA specimens collected by two novice endoscopists in 200 patients with retroperitoneal lesions who had confirmed image-or tissue-based diagnoses of malignancy or benign lesions.Results: In the first 40 performances endoscopists, the false-negative diagnostic rate of EUS-FNA was higher among patients with chronic pancreatitis than in patients without chronic pancreatitis. Patients who underwent FNA through the trans-duodenal puncture route also had lower success cytological diagnosis rate than through the trans-gastric puncture route. The rate of successful cytological diagnoses with EUS-FNA improved after 40 procedures and was not influenced by chronic pancreatitis presentation or difference puncture route.Conclusion: Regarding the learning curve, more than 40 procedures were required to achieve a stable success rate of EUS-FNA. Chronic pancreatitis and trans-duodenal puncture route are the predictive factors for a false-negative FNA cytological result during learning.Trial registration: This was a retrospective study.

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Section: Discussionsupporting

confidence: 90%

Factors affecting cytological results of endoscopic ultrasound guided-fine needle aspiration during learning

Lai

Lin

2020

Diagn Pathol

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“…From the literature, other factors that may influence the diagnostic yield include the mode of anaesthesia, 27 experience of the endoscopist, 16 and specimen preparation for cytopathologic interpretation. 28…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Pancreatic Lesions With Endoscopic Ultrasound and Fine Needle Aspiration

et al. 2020

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Background. Endoscopic ultrasound (EUS) and fine-needle aspiration (FNA) are commonly used for assessing pancreatic lesions. This study aimed to evaluate the diagnostic yield and accuracy of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) in a single tertiary institution. Methods. Consecutive patients who underwent EUS-FNA of the pancreas at Queen Mary Hospital, Hong Kong, from January 2015 to March 2016 were retrospectively reviewed. Endoscopic findings and FNA results were analysed. For patients who subsequently underwent surgical resection of pancreatic lesion, EUS-FNA diagnoses were compared to histopathological findings of surgical specimens to determine its diagnostic accuracy. Results. One hundred twelve EUS-FNA were performed in 99 patients within the study time period and were included for analysis. Sixty-six (66.7%) pancreatic lesions were solid in nature and 33 (33.3%) were cystic. The overall diagnostic yield of EUS-FNA was 70.5% (n = 79). On multivariate analysis, more passes of needle were associated with a higher diagnostic yield (odds ratio = 2.000, P = .049). 57.1% (n = 64) of EUS-FNA results had an impact on management. Sixteen patients with diagnostic EUS-FNA subsequently underwent surgery for resection of the pancreatic lesion. Upon correlation to the histopathological findings of surgical specimens, there were 12 true-positive, 2 true-negative, 0 false-positive, and 2 false-negative cases. Sensitivity was 85.7%, specificity was 100%, positive predictive value was 100%, and negative predictive value was 50%. The diagnostic accuracy of EUS-FNA was 87.5%. Conclusion. EUS-FNA is accurate and reliable for diagnosing pancreatic lesions.

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“…El rango óptimo de pases de cualquier lesión es de 2 a 6 en la mayoría de los estudios. En un estudio de Monhaty, et al el rango de pases de aguja varió de 1 a 14 con una media de 2.6 y una mediana de 2 18 . En un estudio de Erickson, et al el diagnóstico de masas pancreáticas, metástasis hepáticas y lesiones de ganglios linfáticos requirió 5-6 y 2-3 pases, respectivamente, en ausencia de un citopatólogo 19 .…”

Section: Discussionunclassified

Aspectos técnicos del muestreo de ganglios linfáticos por ultrasonido endoscópico

Hernández-Lara

Alonso-Lárraga

Mora-Levy

et al. 2019

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Artículo originAl resumen introducción y objetivo: La precisión diagnóstica de la biopsia por aspiración con aguja fina asistida por ultrasonido endoscópico (USE-BAAF) oscila entre el 68.4 y el 84.3%, dependiendo de varios factores. El objetivo de este estudio es demostrar la seguridad, rendimiento diagnóstico y aspectos técnicos involucrados en la adecuación del muestreo de ganglios linfáticos por USE-BAAF con énfasis en el uso de succión. Material y métodos: Se tomaron 38 biopsias de ganglios linfáticos y se analizaron todas las variables que pudieran tener impacto sobre la adecuación final de las muestras. Se realizó un análisis descriptivo mediante medias y porcentajes, y un análisis inferencial mediante pruebas paramétricas y no paramétricas dependiendo de la distribución y tipo de variable, tomando en cuenta una significancia estadística de p < 0.05. resultados: Se obtuvo material en el 100% de los estudios aunque solo se reportó un 73.7% de muestras adecuadas para el diagnóstico durante la revisión rápida de laminillas y un rendimiento diagnóstico final de un 84.2% después de la revisión del bloque celular (p = 0.031). En nuestro estudio no hubo impacto en la adecuación de la muestra al comparar el uso succión (55.3%) vs. no succión (44.7%) (p = 0.258). conclusiones: La revisión final de bloque celular aumenta el rendimiento diagnóstico de la USE-BAAF en ganglios linfáticos.

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Endoscopic ultrasound guided fine‐needle aspiration: What variables influence diagnostic yield?

Abstract: The diagnostic yield of EUS-FNA is significantly related to the presence of an on-site cytopathologist and endoscopist's skill in procuring diagnostic material.

Cited by 17 publications

References 38 publications

Factors affecting cytological results of endoscopic ultrasound guided-fine needle aspiration during learning

Factors affecting cytological results of endoscopic ultrasound guided-fine needle aspiration during learning

Evaluation of Pancreatic Lesions With Endoscopic Ultrasound and Fine Needle Aspiration

Aspectos técnicos del muestreo de ganglios linfáticos por ultrasonido endoscópico

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