Analysis of Fine-Needle Biopsy vs Fine-Needle Aspiration in Diagnosis of Pancreatic and Abdominal Masses: A Prospective, Multicenter, Randomized Controlled Trial

Cheng, Bin; Zhang, Yueming; Chen, Qian; Sun, Bo; Deng, Zhuang; Shan, Hong; Dou, Lizhou; Wang, Jinglin; Li, Yawen; Yang, Xunan; Jiang, Tianan; Xu, Guoliang; Wang, Guiqi

doi:10.1016/j.cgh.2017.07.010

Cited by 121 publications

(134 citation statements)

References 17 publications

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“…5,6 Additionally, certain neoplasms such as lymphoma, stromal tumors, neuroendocrine tumors, IgG-4 pseudotumoral auto-immune pancreatitis, and well-differentiated adenocarcinoma of the pancreas are often difficult to diagnose by assessment of cytologic material alone, as they require histological exams to assess tissue architecture and cell morphological changes in order to formulate a more accurate diagnosis. 28 The primary aim of our study was to compare the diagnostic accuracies of EUS-FNA and EUS-CNB for solid pancreatic mass lesions. 24 The use of EUS-CNB was proposed as a means to overcome such issues.…”

Section: Discussionmentioning

confidence: 99%

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Endoscopic ultrasound guided fine‐needle aspiration vs core needle biopsy for solid pancreatic lesions: Comparison of diagnostic accuracy and procedural efficiency

Syed

Babich

Rao

et al. 2019

Diagnostic Cytopathology

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Background: Endoscopic ultrasound (EUS) guided core needle biopsies (CNB) are increasingly being performed to diagnose solid pancreatic lesions. However, studies have been conflicting in terms of CNB improving diagnostic accuracy and procedural efficiency vs fine-needle aspiration (FNA), which this study aims to elucidate.Methods: Data were prospectively collected on consecutive patients with solid pancreatic or peripancreatic lesions at a single tertiary care center from November 2015 to November 2016 that underwent either FNA or CNB. Patient demographics, characteristics of lesions, diagnostic accuracy, final and follow-up pathology, use of rapid on-site evaluation (ROSE), complications, and procedure variables were obtained.Results: A total of 75 FNA and 48 CNB were performed; of these, 13 patients had both. Mean passes were lower with CNB compared to FNA (2.4 vs 2.9, P = .02). Use of ROSE was higher for FNA (97.3% vs 68.1%, P = .001). Mean procedure time was shorter with CNB (34.1 minutes vs 51.2 minutes, P = .02) and diagnostic accuracy was similar (89.2% vs 89.4%, P = .98). There was no difference in diagnostic accuracy when ROSE was performed for CNB vs not performed (93.5% vs 85.7%, P = .58).Additionally, diagnostic accuracy of combined FNA and CNB procedures was 92.3%, which was comparable to FNA (P = .73) or CNB (P = .52) alone.Conclusion: FNA and CNB had comparable safety and diagnostic accuracy. Use of CNB resulted in less number of passes and shorter procedure time as compared to FNA. Moreover, diagnostic accuracy for CNB with or without ROSE was similar.K E Y W O R D S core biopsy, endoscopic ultrasound, fine-needle aspiration, pancreatic cancer, pancreatic mass

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Section: Discussionmentioning

confidence: 99%

“…[25][26][27] CNB is also useful in providing a histologically complete specimen for evaluation of tumor biology with a higher diagnostic accuracy than samples collected by EUS-guided FNA. 28 The primary aim of our study was to compare the diagnostic accuracies of EUS-FNA and EUS-CNB for solid pancreatic mass lesions.…”

Section: Methodsmentioning

confidence: 99%

Endoscopic ultrasound guided fine‐needle aspiration vs core needle biopsy for solid pancreatic lesions: Comparison of diagnostic accuracy and procedural efficiency

Syed

Babich

Rao

et al. 2019

Diagnostic Cytopathology

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“…So far, most studies reported an equal performance of FNA and FNB needles, but, recently, two large randomized trials showed a significant diagnostic benefit of FNB . One of these studies, the randomized controlled ASPRO (ASpiration vs PROcore) trial, was carried out in 13 EUS clinics, worldwide .…”

Section: Introductionmentioning

confidence: 99%

“…So far, most studies reported an equal performance of FNA and FNB needles, [6][7][8][9]15 but, recently, two large randomized trials showed a significant diagnostic benefit of FNB. 16,17 One of these studies, the randomized controlled ASPRO (ASpiration vs PROcore) trial, was carried out in 13 EUS clinics, worldwide. 17 This study showed a diagnostic benefit of a novel 20-G FNB needle (ProCore; Cook Medical, Bloomington, IN, USA) over the widely used 25-G FNA needle (EchoTip Ultra; Cook Medical), irrespective of lesion type, size, and the number of passes carried out.…”

Section: Introductionmentioning

confidence: 99%

Agreement on endoscopic ultrasonography‐guided tissue specimens: Comparing a 20‐G fine‐needle biopsy to a 25‐G fine‐needle aspiration needle among academic and non‐academic pathologists

Riet

Cahen

Biermann

et al. 2019

Digestive Endoscopy

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Background and Aim A recently carried out randomized controlled trial showed the benefit of a novel 20‐G fine‐needle biopsy (FNB) over a 25‐G fine‐needle aspiration (FNA) needle. The current study evaluated the reproducibility of these findings among expert academic and non‐academic pathologists. Methods This study was a side‐study of the ASPRO (ASpiration versus PROcore) study. Five centers retrieved 74 (59%) consecutive FNB and 51 (41%) FNA samples from the ASPRO study according to randomization; 64 (51%) pancreatic and 61 (49%) lymph node specimens. Samples were re‐reviewed by five expert academic and five non‐academic pathologists and rated in terms of sample quality and diagnosis. Ratings were compared between needles, expert academic and non‐academic pathologists, target lesions, and cytology versus histological specimens. Results Besides a higher diagnostic accuracy, FNB also provided for a better agreement on diagnosing malignancy (ĸ = 0.59 vs ĸ = 0.76, P < 0.001) and classification according to Bethesda (ĸ = 0.45 vs ĸ = 0.61, P < 0.001). This equally applied for expert academic and non‐academic pathologists and for pancreatic and lymph node specimens. Sample quality was also rated higher for FNB, but agreement ranged from poor (ĸ = 0.04) to fair (ĸ = 0.55). Histology provided better agreement than cytology, but only when a core specimen was obtained with FNB (P = 0.004 vs P = 0.432). Conclusion This study shows that the 20‐G FNB outperforms the 25‐G FNA needle in terms of diagnostic agreement, independent of the background and experience of the pathologist. This endorses use of the 20‐G FNB needle in both expert and lower volume EUS centers.

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“…3 A core biopsy with preserved architecture has the advantage of further subtyping adenocarcinoma and determining the mitotic counts and histologic grade. 5,6 However, an ideal comparison of the diagnostic efficacy of EUS-FNA and EUS-CNB should be conducted in which FNA and CNB are performed at the same site during the same endoscopic procedure. 4 Since the initial use of endoscopic ultrasound-guided core-needle biopsy (EUS-CNB), several studies have been undertaken to compare its diagnostic efficacy with standard FNA cytology for the diagnosis of a pancreatic mass.…”

Section: Introductionmentioning

confidence: 99%

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

Liang

Ikemura

Park

2017

Diagnostic Cytopathology

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Analysis of Fine-Needle Biopsy vs Fine-Needle Aspiration in Diagnosis of Pancreatic and Abdominal Masses: A Prospective, Multicenter, Randomized Controlled Trial

Cited by 121 publications

References 17 publications

Endoscopic ultrasound guided fine‐needle aspiration vs core needle biopsy for solid pancreatic lesions: Comparison of diagnostic accuracy and procedural efficiency

Endoscopic ultrasound guided fine‐needle aspiration vs core needle biopsy for solid pancreatic lesions: Comparison of diagnostic accuracy and procedural efficiency

Agreement on endoscopic ultrasonography‐guided tissue specimens: Comparing a 20‐G fine‐needle biopsy to a 25‐G fine‐needle aspiration needle among academic and non‐academic pathologists

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

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