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

Abstract

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.

Is contrast-enhanced endoscopic ultrasound-guided fine needle biopsy better than conventional fine needle biopsy? A retrospective study in a medical center

“…Furthermore, there were no factors affecting the FNB cytopathological diagnosis rate in this study, which was also comparable with those of our previous study [21] that endoscopists who had achieved the learning curve of conventional EUS-FNA could overcome the difficulty of EUS tissue sampling, such as those due to chronic pancreatitis. Regarding the learning curve, a previous study showed that more than 40 procedures could achieve a stable success rate of conventional EUS-FNA [21]. In this study, there was no obvious difference in the success rate of cytopathological diagnosis along the time sequence.…”

“…The number of conventional FNB needle passes in our study was also compatible with those of another randomized controlled trial that suggested three to four passes [20]. Furthermore, there were no factors affecting the FNB cytopathological diagnosis rate in this study, which was also comparable with those of our previous study [21] that endoscopists who had achieved the learning curve of conventional EUS-FNA could overcome the difficulty of EUS tissue sampling, such as those due to chronic pancreatitis. Regarding the learning curve, a previous study showed that more than 40 procedures could achieve a stable success rate of conventional EUS-FNA [21].…”

Role of Pathologist in the Era of Image-Guided and EUS-Guided Aspirations: A 10-Year Study at a Single Tertiary Care Oncology Institute in North India

“…2), with a 50% fall in 2019 in comparison to 2017 numbers. The shift to imageguided aspirates for superficial lesions is highlighted by many authors in the USA and Europe [2][3][4]8]. In our study, IGFNA for thyroid and breast (both superficial sites) accounted for 80% of procedures in the year of 2019 (shown in Fig.…”

“…The endoscopic and endobronchial ultrasound (EUS/EBUS)-guided procedures for the lung, mediastinum, and pancreatic lesions are becoming more popular since they are minimally invasive with lower complication rates vis-a-vis image-guided FNA (IGFNA) [2]. The experienced endoscopist coupled with adequate workload is required for adoption of EUS/EBUS procedures, thereby limiting this practice to large tertiary care centres [6][7][8].…”

Diagnostic and Therapeutic Indications for Endoscopic Ultrasound (EUS) in Patients with Pancreatic and Biliary Disease—Novel Interventional Procedures

“…Clearly defined quality indicators apply for colonoscopies and ERCP: the cecum intubation rate [ 14 ] for colonoscopy and cannulation of the native papilla of Vater for ERCP [ 15 ]. Unfortunately, there is no clear quality indicator for EUS, but the competence of examiners obviously increases with the number of examinations carried out [ 16 , 17 ]. On that account, it is difficult to define a universal procedural criterion for EUS that would apply to all EUS procedures.…”