La brosse Infinity® améliore les résultats du brossage cytologique des sténoses biliaires malignes

Multicenter randomized trial comparing diagnostic sensitivity and cellular abundance with aggressive versus standard biliary brushing for bile duct stenosis without mass syndrome

“…The high sensitivity for both brushes noted in our study may be a result of these optimization procedures. Furthermore, morbidity for the standard and aggressive brushes was comparable in our study and in the previous pilot and comparative studies [15,16]. Therefore, future trials will need to compare cholangioscopy-guided biopsies with optimized aggressive brushing with the Infinity brush in a homogeneous population of patients with biliary intrinsic strictures.…”

“…First, the primary end point, as evaluated by sensitivity for cholangiocarcinoma, was higher for the aggressive Infinity brush but not significantly, probably owing to the lack of power of our study. The sample size was calculated based on very few previous published data on the aggressive Infinity brush [15]. Therefore, we obviously overestimated the sensitivity of Infinity brushing (79 % in this study vs. 85 % in pilot studies), but also underestimated standard brushing (67 % in this study [thanks to optimization procedures] vs. 50 % from the literature), leading to an insufficient study sample size.…”

“…On the basis of previous unpublished pilot studies, we hypothesized a sensitivity rate of 85 % for cholangiocarcinoma with the aggressive brush (Infinity) vs. 50 % with a standard brush (RX Cytology Brush) [15]. The sample size was calculated with a type-I error of 0.05 (two-sided) and a power of 0.8: the study required a total of 50 patients.…”

“…1). In the very few studies published on the Infinity brush (US Endoscopy, Steris Healthcare, Ohio, USA), sensitivity for cholangiocarcinoma of approximately 85 % and accuracy of 87 % has been reported [15,16]. In contrast, in an initial randomized controlled trial (RCT) on 60 patients with biliary stricture, in which malignant strictures were almost all related to pancreatic cancer and not to biliary duct cancer, the Infinity brush did not show any advantage in terms of sensitivity compared with the conventional cytology brush [17].…”

A prospective randomised study of dense Infinity cytological brush versus regularly used brush in pancreaticobiliary malignancy

“…[1][2][3] In a congress abstract, a relatively new Infinity Õ cytology brush had a promising sensitivity of 85% in detecting malignancy. [4] In another study, the Infinity Õ brush increased the cellularity of bile duct brushings compared with a standard brush. [5] In the prospective randomised study, we aimed to find out if the use of a dense Infinity Õ brush could increase sensitivity in detecting pancreaticobiliary malignancy compared with a regular cytology brush.…”