Comparison between EUS-guided fine-needle aspiration cytology and EUS-guided fine-needle biopsy histology for the evaluation of pancreatic neuroendocrine tumors

Crinò, Stefano Francesco; Ammendola, Serena; Meneghetti, Anna; Bernardoni, Laura; Bellocchi, Maria Cristina Conti; Gabbrielli, Armando; Landoni, Luca; Paiella, Salvatore; Pin, Federico; Parisi, Alice; Mastrosimini, Maria Gaia; Amodio, Antonio; Frulloni, Luca; Facciorusso, Antonio; Larghi, Alberto; Manfrin, Erminia

doi:10.1016/j.pan.2020.12.015

Cited by 80 publications

(69 citation statements)

References 25 publications

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“…A recent pooled analysis by Mohan et al reported a histologic diagnostic rate of 93.9% and adverse event rate of 2.3% with EUS-guided LB, with better outcomes observed with 19G FNA needles [ 7 ]. However, the promising results observed with newer FNB needles, such as the Franseen needle (Acquire ® [Boston Scientific, Marlborough, MA, USA]) and the Fork-tip needle (SharkCore ® [Medtronic, Dublin, Ireland]), in tissue acquisition of pancreatic masses [ 8 , 9 , 10 , 11 , 12 , 13 ] and of subepithelial lesions [ 14 ] also require confirmation in the setting of liver biopsy.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic Yield of Endoscopic Ultrasound-Guided Liver Biopsy in Comparison to Percutaneous Liver Biopsy: A Two-Center Experience

Facciorusso

Ramai

Bellocchi³

et al. 2021

Cancers

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There is scarce and conflicting evidence on the comparison between endoscopic ultrasound (EUS) and percutaneous (PC)-guided liver biopsy (LB). The aim of this study was to compare the two approaches in a series of patients with parenchymal and focal liver lesions. Fifty-four patients undergoing EUS-LB in two high-volume centers between 2017 and 2021 were compared to 62 patients who underwent PC-LB. The primary outcome was diagnostic adequacy rate. The secondary outcomes were diagnostic accuracy, total sample length (TSL), number of complete portal tracts (CPTs), procedural duration, and adverse events. Variables were compared using the Chi-square and Mann–Whitney test. Median age was 56 years (interquartile range 48–69) in the EUS-LB group and 54 years (45–67) in the PC-LB group with most patients being male. Indication for LB was due to parenchymal disease in 50% of patients, whereas the other patients underwent LB due to focal liver lesions. Diagnostic adequacy was 100% in PC-LB and 94.4% in the EUS-LB group (p = 0.74), whereas diagnostic accuracy was 88.8% in the EUS-LB group and 100% in the PC-LB group (p = 0.82). Median TSL was significantly greater in the PC-LB group (27.4 mm, IQR 21–29) when compared to the EUS-LB group (18.5 mm, 10.1–22.4; p = 0.02). The number of complete portal tracts was 21 (11–24) in the PC-LB group and 18.5 (10–23.2) in EUS-LB group (p = 0.09). EUS-LB was a significantly longer procedure (7 min, 5–11 versus 1 min, 1–3 of PC-LB; p < 0.001) and no evidence of adverse events was observed in any of the study groups. These results were confirmed in the subgroup analysis performed according to an indication for LB (parenchymal disease versus focal lesion). Although PC-LB yielded specimens with greater TSL, diagnostic adequacy and accuracy were similar between the two procedures.

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Section: Introductionmentioning

confidence: 99%

Diagnostic Yield of Endoscopic Ultrasound-Guided Liver Biopsy in Comparison to Percutaneous Liver Biopsy: A Two-Center Experience

Facciorusso

Ramai

Bellocchi³

et al. 2021

Cancers

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“…Furthermore, the FNB needle showed a higher histologic core procurement rate than the FNA needle [ 54 ]. This is also true for pancreatic neuroendocrine tumors [ 56 , 57 ]. To date, the superiority of the EUS-FNB needle in tissue sample quality has been widely accepted [ 58 ].…”

Section: Endoscopic Ultrasound-guided Tissue Acquisition (Eus-ta)mentioning

confidence: 98%

Impact of Endoscopic Ultrasound-Guided Tissue Acquisition on Decision-Making in Precision Medicine for Pancreatic Cancer: Beyond Diagnosis

et al. 2021

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Precision medicine in cancer treatment refers to targeted therapy based on the evaluation of biomarkers. Although precision medicine for pancreatic cancer (PC) remains challenging, novel biomarker-based therapies, such as pembrolizumab, olaparib, and entrectinib, have been emerging. Most commonly, endoscopic ultrasound-guided tissue acquisition (EUS-TA) had been used for the diagnosis of PC until now. However, advances in EUS-TA devices and biomarker testing, especially next-generation sequencing, have opened up the possibility of sequencing of various genes even in limited amounts of tissue samples obtained by EUS-TA, and identifying potential genetic alterations as therapeutic targets. Precision medicine benefits only a small population of patients with PC, but biomarker-based therapy has shown promising results in patients who once had no treatment options. Now, the role of EUS-TA has extended beyond diagnosis into decision-making regarding the treatment of PC. In this review, we mainly discuss tissue sampling by EUS-TA for biomarker testing and the current status of precision medicine for PC.

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“…Recently, the availability of needles specifically designed to obtain histological specimens is moving EUS-TA from EUS-FNA to EUS-FNB [61]. In particular, end-cutting needles represented a breakthrough in the field [61,62], and recent studies demonstrated EUS-FNB outperformed EUS-FNA for diagnosis of PanNETs, as for the preoperative evaluation of Ki-67 proliferative index [63][64][65]. In the study by Eusebi et al [63], 91 patients with PanNENs sampled with EUS-FNA and/or EUS-FNB were included.…”

Section: Endoscopic Ultrasound-guided Tissue Acquisitionmentioning

confidence: 99%

“…Moreover, compared to surgical histology, Ki-67 on FNA correlated poorly (r = −0.08) whereas FNB correlated moderately (r = 0.65) [65]. Similarly, Crinò et al [64] compared the yield of 51 EUS-FNA and 128 EUS-FNB samples from small (≤20 mm) NF-PanNETs. A significantly lower rate of Ki-67 feasibility was observed in the EUS-FNA group compared with the EUS-FNB group (88.2% vs. 96.1%, p = 0.04) [64].…”

Section: Endoscopic Ultrasound-guided Tissue Acquisitionmentioning

confidence: 99%

“…Similarly, Crinò et al [64] compared the yield of 51 EUS-FNA and 128 EUS-FNB samples from small (≤20 mm) NF-PanNETs. A significantly lower rate of Ki-67 feasibility was observed in the EUS-FNA group compared with the EUS-FNB group (88.2% vs. 96.1%, p = 0.04) [64]. However, valuable cytological specimens can be obtained also from specimens gathered with EUS-FNB using the touch imprint cytology [66,67].…”

Section: Endoscopic Ultrasound-guided Tissue Acquisitionmentioning

confidence: 99%

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Diagnostic and Interventional Role of Endoscopic Ultrasonography for the Management of Pancreatic Neuroendocrine Neoplasms

Melita

Pallio

Tortora

et al. 2021

JCM

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Pancreatic neuroendocrine neoplasms (PanNENs) are relatively rare, but their incidence has increased significantly in the last decades. Precise diagnosis and prognostic stratification are crucial for proper patient management. Endoscopic ultrasound (EUS) is the modality of choice for diagnosis of solid pancreatic tumors, showing a higher tumor detection rate than other imaging modalities, especially for small size lesions. EUS also serves as a guide for preoperative sampling and other interventions. EUS-tissue acquisition is a safe and highly accurate technique for cyto/histological diagnosis of PanNENs with a well-demonstrated correlation between Ki-67 proliferation index values and tumor grading on EUS and surgical specimens according to the WHO 2017 classification. Furthermore, the possibility of a preoperative EUS-guided fine needle tattooing or fiducial markers placement may help the surgeon to locate small and deep tumors, thus avoiding formal pancreatic resections in favor of parenchymal-sparing surgery. Finally, locoregional ablative treatments using either ethanol injection or radiofrequency ablation have been proposed in recent studies with promising results in order to control symptoms or reduce tumor burden in selected patients unfit for surgery with functioning or non-functioning PanNENs. This article review highlights the current role of EUS in PanNENs management, focusing on the present and future applications of EUS-guided interventions.

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Comparison between EUS-guided fine-needle aspiration cytology and EUS-guided fine-needle biopsy histology for the evaluation of pancreatic neuroendocrine tumors

Cited by 80 publications

References 25 publications

Diagnostic Yield of Endoscopic Ultrasound-Guided Liver Biopsy in Comparison to Percutaneous Liver Biopsy: A Two-Center Experience

Diagnostic Yield of Endoscopic Ultrasound-Guided Liver Biopsy in Comparison to Percutaneous Liver Biopsy: A Two-Center Experience

Impact of Endoscopic Ultrasound-Guided Tissue Acquisition on Decision-Making in Precision Medicine for Pancreatic Cancer: Beyond Diagnosis

Diagnostic and Interventional Role of Endoscopic Ultrasonography for the Management of Pancreatic Neuroendocrine Neoplasms

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