Role of endoscopic ultrasound-guided fine-needle aspiration in the diagnosis of solid pancreatic and peripancreatic lesions: is onsite cytopathology necessary?

Cherian, P. Thomas; Mohan, Pradeep; Douiri, Abdel; Tanière, Philippe; Hejmadi, Rahul; Mahon, Brinder S.

doi:10.1111/j.1477-2574.2010.00180.x

Cited by 41 publications

(48 citation statements)

References 21 publications

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“…1,2 Endoscopic ultrasonography allows for high-resolution imaging of the gastrointestinal tract and adjacent structures, is minimally invasive and has a low risk of complications. 3 It is often used as a complementary procedure to computed tomography and magnetic resonance imaging for the evaluation of suspected malignant disorders, as its high-resolution imaging enables it to detect small lesions that would be difficult to discriminate with either of these 2 other imaging modalities. 3 Fine-needle aspiration guided by endoscopic ultrasonography is routinely used to obtain histological samples of pancreatic lesions, submucosal tumours and lymph nodes.…”

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confidence: 99%

“…3 It is often used as a complementary procedure to computed tomography and magnetic resonance imaging for the evaluation of suspected malignant disorders, as its high-resolution imaging enables it to detect small lesions that would be difficult to discriminate with either of these 2 other imaging modalities. 3 Fine-needle aspiration guided by endoscopic ultrasonography is routinely used to obtain histological samples of pancreatic lesions, submucosal tumours and lymph nodes. [4][5][6][7][8] In concert with the rising burden of gastrointestinal and hepatobiliary conditions in Canada and elsewhere, [9][10][11][12] the applications of interventional endoscopic ultrasonography continue to increase and currently include drainage of pancreatic fluid collection, biliary drainage, celiac plexus nerve blockade and radiologic placement of fiducial markers.…”

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confidence: 99%

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Regional differences in use of endoscopic ultrasonography in Ontario: a population-based retrospective cohort study

et al. 2017

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Background: Endoscopic ultrasonography is a safe and accurate modality for evaluating and managing hepatobiliary and gastrointestinal conditions (malignant and nonmalignant); its use is increasing. The aim of this study was to describe regional trends in the use of endoscopic ultrasonography in Ontario. Methods:We conducted a population-based retrospective cohort study using health administrative databases. We identified all patients who underwent an endoscopic ultrasound procedure in Ontario from 2003 to 2011 using physician billing data. Patient, physician and institution characteristics were examined. The primary outcome was use of endoscopic ultrasonography. Results:We identified 9076 endoscopic ultrasound procedures performed in 8001 patients (3858 women [48.2%]; median patient age at first procedure 59 years). A total of 3066 procedures (33.8%) involved fine-needle aspiration. Use of endoscopic ultrasonography increased 17-fold over the study period. In 2011, people living in the health region with the highest rate of use of endoscopic ultrasonography were more than 4 times more likely to undergo the procedure than people living in the health region with the lowest rate of use (standardized rate 61.6 v. 12.9 per 100 000). About 7 in 10 endoscopic ultrasound procedures were performed in an academic institution or regional cancer centre. All 17 endoscopists performing endoscopic ultrasonography during the study period practised in urban areas.Interpretation: Although the use of endoscopic ultrasonography increased over time in Ontario, there were marked regional differences in use. Provincial needs-and evidence-based initiatives may be needed to narrow the regional gaps in provision of endoscopic ultrasound services in the province. AbstractResearch Research CMAJ OPEN E438CMAJ OPEN, 5(2)

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Regional differences in use of endoscopic ultrasonography in Ontario: a population-based retrospective cohort study

et al. 2017

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“…As suggested above, the advantage of ROSE decreases when the per-pass adequacy rate is high and therefore lesions that are difficult to sample (or inexperienced/low volume centers) may benefit the most. This was also demonstrated in two studies (16,17), where per case adequacy rate was high and final diagnostic yield was not improved with ROSE.…”

Section: Studies Of Pancreatic Massesmentioning

confidence: 63%

Onsite evaluation of endoscopic ultrasound fine needle aspiration: the endosonographer, the cytotechnologist and the cytopathologist

et al. 2017

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Endoscopic ultrasound guided fine needle aspiration (EUS-FNA) has become an essential tool in the management of multiple diseases. Its accuracy is related to different aspects of the technique, one of the most important being the experience and interaction of the endosonographer and pathologist. Certain studies over the past years have highlighted the importance of having rapid on-site evaluation (ROSE) of samples obtained at the time of EUS-FNA. We have reviewed the role of ROSE, performed by the same endosonographer, a cytotechnologist and an expert cytopathologist. The available data suggest that ROSE (either by the endosonographer, the cytotechnologist, or the cytopathologist) improves sample adequacy and diagnostic yield, with the best option to have ROSE performed by an expert cytopathologist. However, if non-ROSE accuracy is already very high, any improvement is harder to achieve.

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“…As imaging techniques advance, some argue that there is no longer a need for rapid evaluation for specimen adequacy, especially in hospitals where this may be logistically difficult [6]. Indeed, some have even proposed methods for optimizing laboratory procedures in order to increase the diagnostic accuracy without using rapid evaluation [7].…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Yield of Endoscopic Ultrasound-Guided Fine-Needle Aspiration Cytology of Porta Hepatis Lesions: A Retrospective Study

Jones

Biederman²,

Draganova‐Tacheva³

et al. 2016

Acta Cytologica

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Objective: Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) has recently been used for the evaluation of various lesions arising in the porta hepatis. The purpose of this study is to evaluate the diagnostic yield of this increasingly utilized approach to porta hepatis lesions. Study Design: A retrospective study of 72 consecutive samples of porta hepatis lesions obtained via EUS-FNA between 2004 and 2015 was conducted. Clinical histories and endoscopic findings were available prior to the diagnostic interpretation. The diagnosis of each lesion was based on its cytologic features on smears, its histologic features on cell block, a comparison with any relevant prior specimens, immunohistochemistry and flow cytometric studies when applicable. Results: A total of 72 lesions (59 lymph nodes, 2 cysts and 11 masses) were biopsied in 70 patients. Adequate specimens were obtained in 65/72 cases (90%). Most of the lymph nodes were benign (n = 40, 67%) and most of the masses were malignant or suspicious (n = 8, 73%). A variety of diagnoses, primary and metastatic, were made, including hepatocellular carcinoma, cholangiocarcinoma and lymphoma. In addition, we have noted a significant increase in the number of EUS-FNAs in recent years. Conclusion: EUS-FNA is an effective and increasingly utilized diagnostic approach for the evaluation of multiple types of lesions in the porta hepatis.

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Role of endoscopic ultrasound-guided fine-needle aspiration in the diagnosis of solid pancreatic and peripancreatic lesions: is onsite cytopathology necessary?

Cited by 41 publications

References 21 publications

Regional differences in use of endoscopic ultrasonography in Ontario: a population-based retrospective cohort study

Regional differences in use of endoscopic ultrasonography in Ontario: a population-based retrospective cohort study

Onsite evaluation of endoscopic ultrasound fine needle aspiration: the endosonographer, the cytotechnologist and the cytopathologist

Diagnostic Yield of Endoscopic Ultrasound-Guided Fine-Needle Aspiration Cytology of Porta Hepatis Lesions: A Retrospective Study

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