Prospective evaluation of EUS-guided fine needle biopsy in pancreatic mass lesions

Larsen, Michael Hareskov; Fristrup, Claus Wilki; Detlefsen, Sönke; Mortensen, Michael Bau

doi:10.1055/s-0043-124078

Cited by 28 publications

(13 citation statements)

References 29 publications

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“…Recently there has been a paradigm shift in tertiary centers from EUS-FNA/Tru-Cut to EUS-FNB for tissue procurement; this was due to the improved diagnostic accuracy and the availability ofROSE [ 12 ]. Recent data on several new FNB needles have shown impressive tissue acquisition and a high rate of solid tissue cores available for more detailed analysis by pathology [ 15 - 17 ]. Earlier studies have shown that these needles are at least as good as standard FNA needles, while they offer additional tissue for special stains with fewer needle passes overall [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

Comparing endoscopic ultrasound-guided core biopsies of solid pancreatic and extrapancreatic lesions: a large single-operator experience with a new fine-needle biopsy needle

Haseeb

Taylor

Adler

2018

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BackgroundThere has been a paradigm shift in tertiary centers from endoscopic ultrasound (EUS) fine-needle aspiration to EUS fine-needle biopsy (EUS-FNB) for tissue acquisition in solid lesions. While data exists on the use of FNB needles in solid pancreatic lesions, very few studies looked at the utility of FNB in solid extrapancreatic lesions. Our aim was to study and compare the technical success and feasibility of EUS-FNB in evaluating solid pancreatic and extrapancreatic lesions using a novel FNB needle.MethodsWe performed a retrospective cohort study of patients with solid masses or lesions needing EUS-guided core biopsy at the University of Utah between May 2016 and November 2017. All core biopsies were obtained using an Acquire™Fine Needle Biopsy Device (Boston Scientific Corporation, Natick MA, USA). Rapid on-site evaluation was performed by a board-certified cytopathologist in all cases.ResultsOne hundred thirty-two patients (87 male) were included. Ninety-nine (73.3%) of the lesions were located in the pancreas. All needle sizes (19 G, 22 G and 25 G) had similar yield. The mean number of passes needed was 2.28±0.7. EUS-FNB of the pancreatic lesions had a diagnostic accuracy of 97.9%, comparable to the 97.2% for the biopsied extra-pancreatic lesions. Only 3 of 132 cases needed re-biopsy at a later date. No immediate adverse events were reported.ConclusionIn this large, single-center study, EUS-FNB with a novel Franseen-design needle was proven to be an effective modality for tissue acquisition from both pancreatic and extrapancreatic solid lesions.

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Section: Discussionmentioning

confidence: 99%

Comparing endoscopic ultrasound-guided core biopsies of solid pancreatic and extrapancreatic lesions: a large single-operator experience with a new fine-needle biopsy needle

Haseeb

Taylor

Adler

2018

aog

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“…EUS‐FNA has been the main modality for pancreatic solid mass lesion sampling for several years with a sensitivity of 85% to 87% and a specificity of 96% to 98% . In recent years, there has been a change in the paradigm of tissue acquisition for these lesions with the emergence of next generation core biopsy needles including ProCore (Cook Medical, Bloomington, Indiana), SharkCore (Medtronic, Dublin, Ireland), and more recently, Acquire Franseen (Boston Scientific, Marlborough, Massachusetts) …”

Section: Introductionmentioning

confidence: 99%

“…1,2 In recent years, there has been a change in the paradigm of tissue acquisition for these lesions with the emergence of next generation core biopsy needles including ProCore (Cook Medical, Bloomington, Indiana), SharkCore (Medtronic, Dublin, Ireland), and more recently, Acquire Franseen (Boston Scientific, Marlborough, Massachusetts). [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] Many studies to date have focused on the ProCore needle. [3][4][5]20,21 Two meta-analyses reported similarly that there was no significant difference in the diagnostic accuracy or the rate of histological core specimen acquisition between the ProCore needle and the standard FNA needles.…”

Section: Introductionmentioning

confidence: 99%

Endoscopic ultrasound‐guided tissue acquisition of solid mass lesions of the pancreas: A retrospective comparison study of fine‐needle aspiration and fine‐needle biopsy

Sweeney

Soong

Goyal

2020

Diagnostic Cytopathology

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Background Although endoscopic ultrasound guided fine‐needle biopsy (EUS‐FNB) has emerged as an alternative to fine‐needle aspiration (FNA) for the sampling of solid pancreatic mass lesions, it remains unclear which method is more effective. We compared the diagnostic yields of FNA, FNB, and combined FNA/FNB at a tertiary care institution. Methods Specimens from EUS‐FNA (04/2014‐08/2017) and EUS‐FNB (10/2015‐08/2017) with SharkCore needle of pancreatic solid mass lesions were retrieved. Clinical, radiologic, and pathologic data was recorded. Pathology results of malignancy/neoplasms with uncertain malignant potential were considered as true positive. The “negative” cases included were with ≥6 months of follow‐up. Nondiagnostic cases showed unremarkable pancreatic tissue, nonpancreatic elements, atypia, or features suspicious for malignancy. Diagnostic yield was defined as percentage of lesions sampled in which a benign or malignant tissue diagnosis, as defined above, was obtained. Statistical comparisons were performed using Fisher's exact test and univariable and multivariable logistic regression analysis. Results The study cohort included 76 FNA only cases, 88 FNB only cases, and 40 combined FNA/FNB cases. Diagnostic yields were 70% (FNA), 70% (FNB), and 83% (FNA/FNB), which were not statistically different. Increase in lesion size and presence of ROSE were significantly associated with a diagnostic outcome on both univariable and multivariable analysis, unlike the number of passes. Conclusion Our results demonstrate that for solid pancreatic lesions, the diagnostic yields of FNA, FNB, and combined FNA and FNB are comparable. Presence of ROSE and increasing lesion size increased the diagnostic yield while the number of passes had no significant impact.

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“…Apart from the improved histological yield, both the Franseen-tip and the Fork-tip needle demonstrated excellent diagnostic accuracy (> 90 %), with or without presence of rapid onsite evaluation (ROSE) 46 . In addition, they were shown to alleviate the need for ROSE, for both solid pancreatic and non-pancreatic lesions, as well as to reduce the required number of needle passes, with a single pass resulting in an onsite diagnostic accuracy in more than 95 % of patients 46 47 50 51 52 53 54 55 56 .…”

Section: Literature Searchmentioning

confidence: 99%

Endoscopic ultrasonography in pancreatic diseases: advances in tissue acquisition

et al. 2019

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Background and study aims Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) improved the diagnostic performance and upgraded the role of endoscopic ultrasonography (EUS) into an interventional modality, able to guide patient management and treatment.This review aimed to highlight the advances, emerging practices, procedural techniques and technological innovations in EUS tissue acquisition in pancreatic diseases. Methods A thorough review of the literature was performed using PubMed to identify articles that describe techniques, advances, and practices in EUS tissue acquisition in gastrointestinal diseases. Conclusion Since the first EUS-FNA procedure, EUS guided-tissue acquisition has been evolving continuously. Development of needles with innovative tip design enabled procurement of larger samples with preserved histological architecture. Moreover, sampling techniques and complementary methods, such as contrast harmonic imaging and EUS-elastography, have been introduced in an effort to improve diagnostic performance and sample adequacy.

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Prospective evaluation of EUS-guided fine needle biopsy in pancreatic mass lesions

Cited by 28 publications

References 29 publications

Comparing endoscopic ultrasound-guided core biopsies of solid pancreatic and extrapancreatic lesions: a large single-operator experience with a new fine-needle biopsy needle

Comparing endoscopic ultrasound-guided core biopsies of solid pancreatic and extrapancreatic lesions: a large single-operator experience with a new fine-needle biopsy needle

Endoscopic ultrasound‐guided tissue acquisition of solid mass lesions of the pancreas: A retrospective comparison study of fine‐needle aspiration and fine‐needle biopsy

Endoscopic ultrasonography in pancreatic diseases: advances in tissue acquisition

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