Randomized trial comparing fanning with standard technique for endoscopic ultrasound-guided fine-needle aspiration of solid pancreatic mass lesions

Abstract

Background and study aims The fanning technique for endoscopic ultrasound-guided fine-needle aspiration (EUS–FNA) involves sampling multiple areas within a lesion with each pass. The aim of this study was to compare the fanning and standard techniques for EUS–FNA of solid pancreatic masses. Patients and methods Consecutive patients with solid pancreatic mass lesions were randomized to undergo EUS–FNA using either the standard or the fanning technique. The main outcome measure was the median number of passes required to establish diagnosis. The secondary outcome measures were the diagnostic accuracy, technical failure, and complication rate of the two techniques. Results Of 54 patients, 26were randomized to the standard technique and 28 to the fanning technique. There was no difference in diagnostic accuracy (76.9% vs. 96.4 %; P=0.05), technical failure or complication rates (none in either cohort). There was a significant difference in both the number of passes required to establish diagnosis (median 1 [interquartile range 1–3] vs. 1 [1–1]; P=0.02) and the percentage of patients in whom a diagnosis was achieved on pass one (57.7% vs. 85.7 %; P = 0.02) between the standard and fanning groups, respectively. Conclusions The fanning technique of FNA was superior to the standard approach because fewer passes were required to establish the diagnosis. If these promising data are confirmed by other investigators, consideration should be given to incorporating the fanning technique into routine practice of EUS–FNA.

Efficacy of endoscopic ultrasonography-guided fine needle aspiration for pancreatic neuroendocrine tumor grading

“…Therefore, methods for obtaining sufficient specimens for immunostaining are required. In two previous reports, Larghi et al [19] used 19G needles, and Hasegawa et al [20] adopted the fanning method reported by Bang et al [25] in 2013. Moreover, Eloubeidi et al [26] performed EUS-FNA without negative pressure and diagnosed 13 cases of PNET.…”

Endoscopic Ultrasound in Pancreatic Cancer: The New Perspective

“…In a randomized trial comparing the fanning and standard techniques, the diagnostic accuracy was nonsignificantly different, although better in the fanning technique (76% vs 96%), with a lower number of passes to establish the diagnosis and better sensitivity after the first pass [66].…”

Randomized Trial Comparing the Flexible 19G and 25G Needles for Endoscopic Ultrasound-Guided Fine Needle Aspiration of Solid Pancreatic Mass Lesions

“…At EUS, during individual FNA passes, after puncturing the pancreatic mass, the stylet was removed, and the needle was moved to-and-fro, 12 to 16 times, at different areas within the lesion using the fanning technique. 10 As described in a previous report, suction was not applied, and the stylet was not reintroduced into the needle after the first pass in any patient. 11 …”