Utility of core biopsy with concurrent ROSE FNA in the diagnosis of pancreatic tumor‐does the biopsy add any diagnostic benefit?

Liang, Yan; Ikemura, Kenji; Park, Ji-Weon

doi:10.1002/dc.23870

Cited by 9 publications

(9 citation statements)

References 21 publications

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“…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 ]. While FNB sampling may obviate the need for ROSE, some in the cytology community still favor FNA over FNB [ 19 ]. Practices with regards to the need for ROSE in patients undergoing FNB remain unstandardized.…”

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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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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“…As previously stated, diagnostic assessment of biliopancreatic lesions plays a crucial role in everyday clinical practice since biliopancreatic adenocarcinomas are still one of the most lethal neoplasms [1]. In this setting, FNA and FNB under EUS guidance represent the standard methods for the diagnosis of solid and cystic pancreatic lesions and have become more and more effective in providing biological diagnostic material [4, 5]. Despite the high-quality performance, many elements may influence the outcome of this procedure such as practical skills and intensive experience of the operator and his/her adequate training, the echogenicity of the lesion, adequacy, and choice of the most suitable part of the lesion to sample, site of the lesion, needle properties such as type and size, number of passes, ROSE assessment, and type of processing methods.…”

Section: Discussion/conclusionmentioning

confidence: 99%

“…The acquisition of biological material by endoscopic ultrasound (EUS) evaluation has proved to be the most effective diagnostic instrument, using 2 techniques: the first implemented and older method is fine needle aspiration (FNA), while fine needle biopsy (FNB) has emerged as an alternative procedure in more recent years. EUS-FNA represents a very useful, safe, and highly accurate diagnostic tool because needles are generally more flexible and easier to use, as confirmed in several studies in the last 2 decades [4, 5]. The greatest strength of FNA is its excellent specificity (around 100% in nearly all studies), while there are still conflicting results regarding its sensitivity (which ranges from 85 to 93% in most trials) and sample adequacy [5, 6].…”

Section: Introductionmentioning

confidence: 99%

“…EUS-FNA represents a very useful, safe, and highly accurate diagnostic tool because needles are generally more flexible and easier to use, as confirmed in several studies in the last 2 decades [4, 5]. The greatest strength of FNA is its excellent specificity (around 100% in nearly all studies), while there are still conflicting results regarding its sensitivity (which ranges from 85 to 93% in most trials) and sample adequacy [5, 6].…”

Section: Introductionmentioning

confidence: 99%

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Fine Needle Aspiration versus Fine Needle Biopsy of Biliopancreatic Lesions: Are They Really Opposing Techniques or Can They Be Complementary? Our Experience in a Large Cohort of Cases from a Single Institution

et al. 2020

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Introduction: Nowadays, endoscopic ultrasound (EUS)-guided fine needle aspiration (FNA), and fine needle biopsy (FNB) are considered the best procedures for the diagnosis of biliopancreatic lesions. These methods represent a milestone since they proved to be both safe for the patient and useful to achieve diagnostic material useful to plan the best treatment strategy. Objective: Since in the literature, a debate between cytology and histology supporters is still ongoing and the trend is changing in favor of FNB, we would like to present our experience about the diagnostic yield of FNA and FNB. The aim of our study is to highlight FNA versus FNB diagnostic role of biliopancreatic lesions, highlight advantages, and drawbacks of these procedures, and our view on these 2 procedures and whether they should still be considered complementary or opposing techniques. Methods: We retrospectively reviewed our hospital series of 469 EUS diagnostics procedures of biliopancreatic lesions performed in 419 patients, between 2015 and 2019. Results: The overall adequacy rates of FNA and FNB were, respectively, 98.9 and 100%. Stratifying cases according to anatomic location of the mass (pancreas vs. biliary system), we detected 168 malignancies out of 349 pancreatic lesions (168/349; 48.1%), while biliary system cases positive for malignancy represented 33.8% (23/68 cases) (p value = 0.045, χ2 test). As for concomitant FNB, our series displayed a high rate of diagnostic concordance (88.8%). Conclusions: Despite numerous data published, it is still unclear which is the most feasible method to use; therefore, we compared FNA, FNB, or their combination to understand the best applicable technique. Our experience confirmed that FNA is extremely efficient in the diagnosis of biliopancreatic lesions, especially in the hands of expert endoscopists and pathologists. Considering anatomic location, EUS-FNA is more accurate for mass-forming neoplasms in the pancreatic parenchyma rather than for lesions of the biliary system. Moreover, concomitant FNB usually confirmed the cytological diagnosis, allowing a deeper immunohistochemical characterization of the neoplasia. This proves that a “pure” cytology and “pure” histology approach should be looked differently since these are complementary techniques especially if we can obtain a cellblock from FNA.

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“…Endoscopic ultrasound‐guided fine‐needle aspiration (EUS‐FNA) cytological examination has emerged as a minimally invasive technique for the sampling of various tumors, and its diagnostic utility and high sensitivity have been reported in various organs including the lung and pancreas . Moreover, EUS‐FNA biopsy allows the collection of sufficient amounts of tumor tissue, required to make a cell block for histopathological and immunohistochemical analyses.…”

Section: Introductionmentioning

confidence: 99%

Utility of endoscopic ultrasound‐guided fine‐needle aspiration cytology in rapid on‐site evaluation for the diagnosis of gastric submucosal tumors: Retrospective analysis of a single‐center experience

Sandoh

Ishida

Okano

et al. 2019

Diagnostic Cytopathology

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Background Recently, there have been reports of endoscopic ultrasound‐guided fine‐needle aspiration (EUS‐FNA) cytology being used for the diagnosis of various kinds of tumors. This method has also been adopted in the diagnosis of gastric submucosal tumors (SMTs). The aim of this study was to analyze the utility of EUS‐FNA cytological examination in rapid on‐site evaluation (ROSE) for gastric SMTs. Methods Retrospective analyses of the cytological specimens of EUS‐FNA in ROSE for gastric SMTs and determination of the diagnostic accuracy of EUS‐FNA combined with immunohistochemical analysis of cell blocks and surgically resected specimens were performed. Results A total of 110 patients were enrolled in this study. The most common cytodiagnosis was spindle cell tumor (62 patients, 55.5%), followed by negative for tumor (34 patients), and malignant lymphoma and adenocarcinoma (five patients each). Cell blocks were prepared for 60 of the patients (96.8%), cytologically diagnosed with spindle cell tumor. Immunohistochemical analyses using cell block revealed gastrointestinal stromal tumor (GIST, c‐kit+/desmin−, 49 patients) and leiomyoma (desmin+/c‐kit−, five patients). Thus, using EUS‐FNA specimens, 83.1% of GIST patients were pre‐operatively diagnosed. Conclusions EUS‐FNA cytological examination in ROSE for gastric SMTs aided in the collection of sufficient amounts of tumor tissues for preparing cell blocks. This method led to a high rate of accurate pre‐operative diagnosis in patients with gastric SMTs.

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Utility of core biopsy with concurrent ROSE FNA in the diagnosis of pancreatic tumor‐does the biopsy add any diagnostic benefit?

Abstract: EUS-guided FNA is a superior method of assessing solid pancreatic lesion and pancreatic malignancy with better diagnostic yield and higher sensitivity than EUS-CNB.

Cited by 9 publications

References 21 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

Fine Needle Aspiration versus Fine Needle Biopsy of Biliopancreatic Lesions: Are They Really Opposing Techniques or Can They Be Complementary? Our Experience in a Large Cohort of Cases from a Single Institution

Utility of endoscopic ultrasound‐guided fine‐needle aspiration cytology in rapid on‐site evaluation for the diagnosis of gastric submucosal tumors: Retrospective analysis of a single‐center experience

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