Yield of EUS-guided FNA of pancreatic masses in the presence or the absence of chronic pancreatitis

Varadarajulu, Shyam; Tamhane, Ashutosh; Eloubeidi, Mohamad A.

doi:10.1016/j.gie.2005.06.051

Cited by 338 publications

(208 citation statements)

References 42 publications

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“…The accuracy of EUS-FNA and cytologic analysis was lower in other studies where chronic pancreatitis features were present [28], which can impose the increase in the number of passes [29]. This was not proved in our group, perhaps due to the fact that there were only three patients with chronic pancreatitis features.…”

Section: Discussioncontrasting

confidence: 72%

Performance of the Standard 22G Needle for Endoscopic Ultrasound-guided Tissue Core Biopsy in Pancreatic Cancer

Seicean

Gheorghiu

Zaharia

et al. 2016

JGLD

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Background & Aim: Endoscopic ultrasonography (EUS) and EUS-guided fine-needle aspiration (EUS-FNA) are considered good tools for the diagnosis of pancreatic cancer and for obtaining material for cytology or histology. The accuracy of EUS-FNA can rise to 85-95%, but it is lower in cases with a chronic pancreatitis background or with previous biliary stenting. We aimed to establish the diagnostic yield of the visible length of the core biopsy samples in pancreatic cancer by using one single type of standard 22G needle and to evaluate the factors which can influence the results. Method: EUS-FNA was performed by using a 22G standard needle on patients prospectively recruited with the suspicion of pancreatic masses on transabdominal ultrasound or CT scan over a period of eight months. The number of passes was limited by the length of the core obtained. The final diagnosis was based on EUS-FNA or hepatic biopsy for their metastasis or by follow up every three month by imaging methods. Results: The study included 118 patients. Previous stents were present in 10 patients and chronic pancreatitis features were found in 3 patients. The procedure sensitivity was 89% and the global accuracy was 89%. The presence of biliary stents did not impede the accuracy of results. The number of passes did not influence the results. Conclusions: The diagnostic rate of core biopsy by using 22G needles had a high accuracy and it is safe when the length of core dictates the number of passes. The presence of biliary stents did not influence the results. Abbreviations: AUC: area under the curve; EUS: endoscopic ultrasonography; EUS-FNA: fine needle aspiration under endosonographic guidance; FNA: fine needle aspiration; INR: international normalised ratio; OR: odds ratio.

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Section: Discussioncontrasting

confidence: 72%

Performance of the Standard 22G Needle for Endoscopic Ultrasound-guided Tissue Core Biopsy in Pancreatic Cancer

Seicean

Gheorghiu

Zaharia

et al. 2016

JGLD

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“…However, differentiation between pancreatic cancer and focal pancreatitis remains a challenge. EUS can guide fine-needle aspiration (EUS-FNA) for the collection of cytological samples from pancreatic lesions with a very high overall diagnostic accuracy (3)(4)(5)(6)(7). EUS-FNA may be, however, technically demanding, and multiple puncturing of pancreatic lesions may be needed to obtain adequate material for cytological or microhistological evaluation.…”

Section: Introductionmentioning

confidence: 99%

Second-generation endoscopic ultrasound elastography in the differential diagnosis of solid pancreatic masses: Pancreatic cancer vs. inflammatory mass in chronic pancreatitis

Garcia

Noia

Castro

et al. 2009

Rev. esp. enferm. dig.

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Endoscopic ultrasonography (EUS) is considered one of the most accurate methods for the diagnosis and staging of pancreatic tumors. EUS-guided fine-needle aspiration (FNA) allows to increase the diagnostic accuracy of EUS in this setting; however, it is technically demanding (a pathologist is also essential) and is furthermore associated with small, but not insignificant morbidity. EUS pancreatic elastography, by analyzing tissue stiffness, arises as a new and very useful tool for the differential diagnosis of solid pancreatic masses. Elastography provides specific patterns supporting the benign or malignant nature of the disease. However, there is a handicap related to the subjective interpretation of images. Second-generation elastography has been recently developed, and allows a quantitative analysis of tissue stiffness. It is based on the determination of a strain ratio (obtained after comparing the strain value of the mass to a strain value from a control area in the region under study). We present two cases reflecting the usefulness of second-generation elastography in the differential diagnosis between pancreatic adenocarcinoma and an inflammatory mass in the context of chronic pancreatitis. We found significant differences between both masses in the strain ratio values (25.46% in the pancreatic adenocarcinoma vs. 2.35% in the inflammatory mass). Second-generation elastography is a very useful tool for the differential diagnosis of solid pancreatic masses.Key words: Endoscopic ultrasound. Elastography. Second-generation Elastography. Pancreatic tumors. INTRODUCTIONEndoscopic ultrasonography (EUS) has become a basic tool for the study of pancreatic diseases, and is considered one of the most accurate methods for the diagnosis and staging of both chronic inflammatory and neoplastic pancreatic diseases (1,2). However, differentiation between pancreatic cancer and focal pancreatitis remains a challenge. EUS can guide fine-needle aspiration (EUS-FNA) for the collection of cytological samples from pancreatic lesions with a very high overall diagnostic accuracy (3-7). EUS-FNA may be, however, technically demanding, and multiple puncturing of pancreatic lesions may be needed to obtain adequate material for cytological or microhistological evaluation. EUS-FNA of the pancreas, despite being considered very safe, is furthermore associated with a small, but not insignificant morbidity (8,9).Elastography is a method for the real-time evaluation of tissue stiffness, which has been used for the analysis of superficial organ lesions such as those of the breast (10-13). Images obtained by elastography represent tissue elasticity, which may reflect histopathological differences (14). The association of this technology with EUS has implied a significant advance in the management of pancreatic diseases, mainly in the differential diagnosis of pancreatic tumors (15). A new advance has been recently developed -secondgeneration elastography. This technique allows not only a qualitative elastographic analysis, but also a...

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“…The presence of features of chronic pancreatitis was associated with lower accuracy of EUS-FNA for the differential diagnosis of pancreatic masses (73% vs 91%) and may necessitate a higher number of passes to establish the diagnosis [70]. The presence of stents (either plastic or metallic) usually does not impede EUS-FNA [71][72][73], although the stent has to be placed at least one day before performing EUS-FNA [72].…”

Section: Endoscopic Ultrasound Fine-needle Aspirationmentioning

confidence: 99%

Endoscopic Ultrasound in Pancreatic Cancer: The New Perspective

Seicean¹

2014

Pancreatic Cancer - Insights Into Molecular Mechanisms and Novel Approaches to Early Detection and Treatment

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Yield of EUS-guided FNA of pancreatic masses in the presence or the absence of chronic pancreatitis

Cited by 338 publications

References 42 publications

Performance of the Standard 22G Needle for Endoscopic Ultrasound-guided Tissue Core Biopsy in Pancreatic Cancer

Performance of the Standard 22G Needle for Endoscopic Ultrasound-guided Tissue Core Biopsy in Pancreatic Cancer

Second-generation endoscopic ultrasound elastography in the differential diagnosis of solid pancreatic masses: Pancreatic cancer vs. inflammatory mass in chronic pancreatitis

Endoscopic Ultrasound in Pancreatic Cancer: The New Perspective

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