Pancreatic FNA in 1000 cases: a comparison of imaging modalities

Volmar, Keith E.; Vollmer, Robin T.; Jowell, Paul S.; Nelson, Rendon C.; Xie, H. Bill

doi:10.1016/s0016-5107(05)00364-0

Cited by 197 publications

(120 citation statements)

References 35 publications

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“…Distinguishing adenocarcinoma from local pancreatitis has important implications for prognosis and the method of treatment. A review of the literature concerning EUS-FNA of pancreatic lesions reveals a 78-95% sensitivity, 75-100% specificity, 98-100% PPV, 46-80% NPV and 78-95% accuracy (24)(25)(26). The present study found that the accuracy of diagnosis of pancreatic lesions was 85.48% (53/62; 95% CI 76.71-94.25%; Table II).…”

Section: Discussionsupporting

confidence: 55%

Role of endoscopic ultrasound-guided fine needle aspiration in the diagnosis of mass lesions

Han

Lin

Zhang

et al. 2016

Experimental and Therapeutic Medicine

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Abstract. Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is an accurate technique for sampling the pancreas and mediastinum; however, limited data are available for other mass lesions. The aim of this study was to explore the value of EUS-FNA in the differential diagnosis of all mass lesions. Data from patients who underwent EUS-FNA for the diagnosis of mass lesions, including pancreatic, mediastinal, celiac and retroperitoneal lesions were retrospectively analyzed. The accuracy was calculated by comparing the results of FNA with the results of pathological examination or follow-up surveillances in non-operated cases. A total of 150 cases were included. The location of the mass varied from the pancreas (n=62) to the mediastinum (n=29), gastrointestinal tract (n=36), celiac cavity and retroperitoneum (n=23). The sensitivity and Youden ' s index of EUS-FNA in the diagnosis of all lesions were 92.97% and 0.93 respectively. The accuracy of diagnosis of pancreatic, mediastinal, gastrointestinal, celiac and retroperitoneal lesions was 85.48, 89.66, 83.33 and 78.23%, respectively. Masses were categorized into parenchymal organs (n=66), luminal organs (n=36) and enlarged lymph nodes (n=33). Lesions in parenchymal organs were likely to be bigger than those in luminal organs (P=0.03) and enlarged lymph nodes (P=0.01). For solid and cystic masses, which constituted 63.3 and 14.7% of the total masses, no significant difference in diagnostic accuracy was observed (P=0.56); however, lesion sizes were significantly different between these two groups (P=0.04) and the majority of cystic masses were identified in women (P=0.03). Malignant lesions were more common in older (P=0.01) and male (P=0.03) patients. In conclusion, EUS-FNA is an effective tool in the diagnosis of unexplained mass lesions; it influences the management of patients by enabling the appropriate treatment to be identified.

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Section: Discussionsupporting

confidence: 55%

Role of endoscopic ultrasound-guided fine needle aspiration in the diagnosis of mass lesions

Han

Lin

Zhang

et al. 2016

Experimental and Therapeutic Medicine

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“…120 Several studies have assessed EUS-FNA receiver operating characteristics by including only pancreatic cancer patients. [121][122][123][124][125][126][127][128][129][130][131][132] The initial reports showed a sensitivity of 85-95%, with a specificity close to 100%. 3, [121][122][123][124][125] The reports from the past 5 years also showed a high sensitivity of the procedure between 80% and 95%, with a specificity of 100%.…”

Section: Eus-fnamentioning

confidence: 99%

Role of endoscopic ultrasound in the diagnosis and staging of pancreatic cancer

Săftoiu

Vilmann

2008

J of Clinical Ultrasound

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Early diagnosis of pancreatic cancer remains a difficult task, and multiple imaging tests have been proposed over the years. The aim of this review is to describe the current role of endoscopic ultrasound (EUS) for the diagnosis and staging of patients with pancreatic cancer. A detailed search of MEDLINE between 1980 and 2007 was performed using the following keywords: pancreatic cancer, endoscopic ultrasound, diagnosis, and staging. References of the selected articles were also browsed and consulted. Despite progress made with other imaging methods, EUS is still considered to be superior for the detection of clinically suspected lesions, especially if the results of other cross-sectional imaging modalities are equivocal. The major advantage of EUS is the high negative predictive value that approaches 100%, indicating that the absence of a focal mass reliably excludes pancreatic cancer. The introduction of EUS-guided fine needle aspiration allows a preoperative diagnosis in patients with resectable cancer, as well as a confirmation of diagnosis before chemoradiotherapy for those that are not. This comprehensive review highlighted the diagnostic capabilities of EUS including the newest refinements such as contrast-enhanced EUS, EUS elastography, and 3-dimensional EUS. The place of EUSguided biopsy is also emphasized, including the addition of molecular marker techniques.

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“…The strength of EUS is its ability to detect and aspirate small cystic lesions with a high level of safety [38]. EUS is more accurate in the evaluation of lesions less than 3 cm in diameter [39]. The macrocystic variant of serous cystadenomas can be diagnosed with EUS using a combination of a thick cyst wall, the presence of microcysts, and a low cyst fluid CEA [40].…”

Section: Diagnostic Methodsmentioning

confidence: 99%

Cystic pancreatic lesions: Can we diagnose them accurately what to look for? FNA marker molecular analysis resection, surveillance, or endoscopic treatment?

Brugge

2006

Endoscopy

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IntroductionCystic lesions of the pancreas consist of a spectrum of benign, pre-malignant, and malignant malignancies. In the past, cystic neoplasms of the pancreas were thought to be relatively rare, but the widespread use of cross sectional imaging has dramatically increased ability to detect these lesions. Although the vast majority of pancreatic cysts are discovered incidentally, large or invasive lesions may produce sufficient symptoms to cause the patient to seek medical attention.Cystic neoplasms are often confused or misdiagnosed as pseudocysts or peripancreatic collections of inflammatory fluid that may morphologically mimic cystic neoplasms. Furthermore, the presenting symptoms of pseudocysts may be identical to the symptoms associated with cystic neoplasms.Cystic neoplasms of the pancreas are traditionally organized by the type of lining epithelium since this feature dominates the risk of malignancy and management [1] ( Table 1). There are three types of mucinous lesions, benign mucinous cystadenomas, malignant mucinous cystic lesions, and intra-ductal papillary mucinous neoplasms (IPMNs). The non-mucinous lesions include serous cystadenomas, cystic endocrine tumors and other rare lesions. PrevalenceThe prevalence of pancreatic cysts has been examined with autopsy examinations of the pancreas in adults without known pancreatic disease. The prevalence of pancreatic cysts found at autopsies in Japan was approximately 73 of 300 autopsies (24.3 %) cases [2]. The prevalence of cysts increased with increasing age of the patient. The cysts were located throughout the pancreatic parenchyma and were not related to chronic pancreatitis. The epithelium of the cysts displayed a spectrum of neoplastic change, including atypical hyperplasia (16.4 %); carcinoma in situ (3.4 %).

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Pancreatic FNA in 1000 cases: a comparison of imaging modalities

Cited by 197 publications

References 35 publications

Role of endoscopic ultrasound-guided fine needle aspiration in the diagnosis of mass lesions

Role of endoscopic ultrasound-guided fine needle aspiration in the diagnosis of mass lesions

Role of endoscopic ultrasound in the diagnosis and staging of pancreatic cancer

Cystic pancreatic lesions: Can we diagnose them accurately what to look for? FNA marker molecular analysis resection, surveillance, or endoscopic treatment?

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