Comparison of Endoscopic Ultrasound–Fine-Needle Aspiration and Endoscopic Ultrasound–Fine-Needle Biopsy for Solid Lesions in a Multicenter, Randomized Trial

Nagula, Satish; Pourmand, Kamron; Aslanian, Harry R.; Bucobo, Juan Carlos; Gonda, Tamas A.; Gonzalez, Susana; Goodman, Adam; Gross, Seth A.; Ho, Sammy; DiMaio, Christopher J.; Kim, Michelle K.; Pais, Shireen; Poneros, John M.; Robbins, David H.; Schnoll‐Sussman, Felice; Sethi, Amrita; Buscaglia, Jonathan M.

doi:10.1016/j.cgh.2017.06.013

Cited by 32 publications

(35 citation statements)

References 22 publications

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“…EUS‐FNA has been the main modality for pancreatic solid mass lesion sampling for several years with a sensitivity of 85% to 87% and a specificity of 96% to 98% . In recent years, there has been a change in the paradigm of tissue acquisition for these lesions with the emergence of next generation core biopsy needles including ProCore (Cook Medical, Bloomington, Indiana), SharkCore (Medtronic, Dublin, Ireland), and more recently, Acquire Franseen (Boston Scientific, Marlborough, Massachusetts) …”

Section: Introductionmentioning

confidence: 99%

“…Many studies to date have focused on the ProCore needle . Two meta‐analyses reported similarly that there was no significant difference in the diagnostic accuracy or the rate of histological core specimen acquisition between the ProCore needle and the standard FNA needles.…”

Section: Introductionmentioning

confidence: 99%

“…1,2 In recent years, there has been a change in the paradigm of tissue acquisition for these lesions with the emergence of next generation core biopsy needles including ProCore (Cook Medical, Bloomington, Indiana), SharkCore (Medtronic, Dublin, Ireland), and more recently, Acquire Franseen (Boston Scientific, Marlborough, Massachusetts). [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] Many studies to date have focused on the ProCore needle. [3][4][5]20,21 Two meta-analyses reported similarly that there was no significant difference in the diagnostic accuracy or the rate of histological core specimen acquisition between the ProCore needle and the standard FNA needles.…”

Section: Introductionmentioning

confidence: 99%

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Endoscopic ultrasound‐guided tissue acquisition of solid mass lesions of the pancreas: A retrospective comparison study of fine‐needle aspiration and fine‐needle biopsy

Sweeney

Soong

Goyal

2020

Diagnostic Cytopathology

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Background Although endoscopic ultrasound guided fine‐needle biopsy (EUS‐FNB) has emerged as an alternative to fine‐needle aspiration (FNA) for the sampling of solid pancreatic mass lesions, it remains unclear which method is more effective. We compared the diagnostic yields of FNA, FNB, and combined FNA/FNB at a tertiary care institution. Methods Specimens from EUS‐FNA (04/2014‐08/2017) and EUS‐FNB (10/2015‐08/2017) with SharkCore needle of pancreatic solid mass lesions were retrieved. Clinical, radiologic, and pathologic data was recorded. Pathology results of malignancy/neoplasms with uncertain malignant potential were considered as true positive. The “negative” cases included were with ≥6 months of follow‐up. Nondiagnostic cases showed unremarkable pancreatic tissue, nonpancreatic elements, atypia, or features suspicious for malignancy. Diagnostic yield was defined as percentage of lesions sampled in which a benign or malignant tissue diagnosis, as defined above, was obtained. Statistical comparisons were performed using Fisher's exact test and univariable and multivariable logistic regression analysis. Results The study cohort included 76 FNA only cases, 88 FNB only cases, and 40 combined FNA/FNB cases. Diagnostic yields were 70% (FNA), 70% (FNB), and 83% (FNA/FNB), which were not statistically different. Increase in lesion size and presence of ROSE were significantly associated with a diagnostic outcome on both univariable and multivariable analysis, unlike the number of passes. Conclusion Our results demonstrate that for solid pancreatic lesions, the diagnostic yields of FNA, FNB, and combined FNA and FNB are comparable. Presence of ROSE and increasing lesion size increased the diagnostic yield while the number of passes had no significant impact.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Endoscopic ultrasound‐guided tissue acquisition of solid mass lesions of the pancreas: A retrospective comparison study of fine‐needle aspiration and fine‐needle biopsy

Sweeney

Soong

Goyal

2020

Diagnostic Cytopathology

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“…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.…”

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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“…80 With a comparable number of passes there appears to be no differences in adequacy rates between CNB and FNAB for diagnosis of malignancy. 200 Adequacy is high only if multiple passes are performed and, for FNAB, if the samples evaluated immediately by ROSE. [201][202][203] However, EUS needle biopsy has advantages over open biopsy to sample chemotherapy-naïve tumors and to provide material for genomic analysis, for example KRAS mutations 204 and immunophenotype analysis.…”

Section: Breastmentioning

confidence: 99%

Needle Biopsy Adequacy in the Era of Precision Medicine and Value-Based Health Care

Pritzker

Nieminen

2019

Archives of Pathology &Amp; Laboratory Medicine

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Context.— Needle biopsy of diseased tissue is an essential diagnostic tool that is becoming even more important as precision medicine develops. However, the capability of this modality to efficiently provide samples adequate for diagnostic and prognostic analysis remains quite limited relative to current diagnostic needs. For physicians and patients, inadequate biopsy frequently leads to diagnostic delay, procedure duplication, or insufficient information about tumor biology leading to delay in treatment; for health systems, this results in substantial incremental costs and inefficient use of scarce specialized diagnostic resources. Objective.— To review current needle biopsy technology, devices, and practice with a perspective to identify current limitations and opportunities for improvement in the context of advancing precision medicine. Data Sources.— PubMed searches of fine-needle aspiration and core needle biopsy devices and similar technologies were made generally, by tissue site, and by adequacy as well as by health economics of these technologies. Conclusions.— Needle biopsy adequacy can be improved by recognizing the importance of this diagnostic tool by promoting common criteria for needle biopsy adequacy; by optimizing needle biopsy procedural technique, technologies, clinical practice, professional education, and quality assurance; and by bundling biopsy procedure costs with downstream diagnostic modalities to provide better accountability and incentives to improve the diagnostic process.

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Comparison of Endoscopic Ultrasound–Fine-Needle Aspiration and Endoscopic Ultrasound–Fine-Needle Biopsy for Solid Lesions in a Multicenter, Randomized Trial

Cited by 32 publications

References 22 publications

Endoscopic ultrasound‐guided tissue acquisition of solid mass lesions of the pancreas: A retrospective comparison study of fine‐needle aspiration and fine‐needle biopsy

Endoscopic ultrasound‐guided tissue acquisition of solid mass lesions of the pancreas: A retrospective comparison study of fine‐needle aspiration and fine‐needle biopsy

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

Needle Biopsy Adequacy in the Era of Precision Medicine and Value-Based Health Care

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