Diagnostic accuracy of endoscopic ultrasound‐guided fine needle aspiration for suspected pancreatic malignancy in relation to the size of lesions

Uehara, Hiroyuki; Ikezawa, Kenji; Kawada, Natsuko; Fukutake, Nobuyasu; Katayama, Kazuhiro; Takakura, Rena; Takano, Yasuna; Ishikawa, Osamu; Takenaka, Akemi

doi:10.1111/j.1440-1746.2011.06747.x

Cited by 98 publications

(95 citation statements)

References 27 publications

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“…A 25-gauge needle is therefore recommended to puncture the head of the pancreas 4 . Several studies have compared the performance characteristics of a 22-gauge needle with those of a 25-gauge FNA needle for sampling pancreatic masses, but most have failed to demonstrate superiority of either needle [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] . A recent systematic review and meta-analysis of EUS-FNA for solid pancreatic masses, including a large cohort of patients, revealed that a 25-gauge needle was more sensitive than a 22-gauge needle 23 .…”

Section: Discussionmentioning

confidence: 99%

High and low negative pressure suction techniques in EUS-guided fine-needle tissue acquisition by using 25-gauge needles: a multicenter, prospective, randomized, controlled trial

Kudo

Kawakami

Hayashi

et al. 2014

Gastrointestinal Endoscopy

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Section: Discussionmentioning

confidence: 99%

High and low negative pressure suction techniques in EUS-guided fine-needle tissue acquisition by using 25-gauge needles: a multicenter, prospective, randomized, controlled trial

Kudo

Kawakami

Hayashi

et al. 2014

Gastrointestinal Endoscopy

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“…EUS combined with FNA (EUS-FNA) has been demonstrated to be more accurate in diagnosing solid pancreatic lesions and has gained wide acceptance [7]. However, the reported sensitivity and specificity of EUS-FNA vary greatly across studies (sensitivity: 73.20–96.50 %; specificity: 71.40–100 %) [7–26]. In addition, the majority of previous studies were dependent on single-center trials.…”

Section: Introductionmentioning

confidence: 99%

Endoscopic ultrasonography with fine-needle aspiration for histological diagnosis of solid pancreatic masses: a meta-analysis of diagnostic accuracy studies

et al. 2016

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BackgroundPrevious studies have demonstrated that endoscopic ultrasound-fine needle aspiration (EUS-FNA) is a reliable tool for diagnosing pancreatic lesions; however, the reported sensitivity and specificity vary greatly across studies. The aim of this study was to pool the existing literature and assess the overall performance of EUS-FNA in the diagnosis of solid pancreatic lesions.MethodsA systematic search of MEDLINE, Cochrane Database for Systematic Reviews, and EMBASE was performed to identify original and review articles published between January 1995 and January 2014 that reported the accuracy of EUS-FNA in the diagnosis of pancreatic masses. Quality of the included studies was assessed using the quality assessment of diagnosis accuracy studies score tool. Meta-DiSc software was used to calculate the pooled sensitivity and specificity, positive and negative likelihood ratios, and to construct the summary receiver operating characteristics curve.ResultsTwenty studies involving a total of 2,761 patients were included in the study. The pooled sensitivity and specificity of EUS-FNA in the diagnosis of solid pancreatic lesions were 90.8 % [95 % confidence interval (CI), 89.4–92 %] and 96.5 % (95 % CI, 94.8–97.7 %), respectively. The positive and negative likelihood ratios were 14.8 (95 % CI, 8.0–27.3) and 0.12 (95 % CI, 0.09–0.16), respectively. The overall diagnostic accuracy was 91.0 %.ConclusionsOur findings suggest that EUS-FNA has high sensitivity and specificity in the diagnosis of solid pancreatic lesions.

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“…Repeat biopsies raise the costs of diagnosis and constitutively require extra patient discomfort. Several studies have established the benefits of on-site evaluation of adequacy (OSEA) for enhancing the diagnostic yield of the pancreatic FNA procedure [7,8,9,10,11,12]. When viewed on the scale of a large institution, these benefits also translate into cost savings [13,14].…”

Section: Introductionmentioning

confidence: 99%

Cytotechnologist On-Site Evaluation of Pancreas Fine Needle Aspiration Adequacy: Comparison with Cytopathologists and Correlation with the Final Interpretation

Olson¹,

Ali²

2012

Acta Cytologica

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Objective: To compare on-site evaluations of adequacy (OSEA) of endoscopic ultrasound (EUS)-guided fine needle aspiration (FNA) of the pancreas performed by cytotechnologists and cytopathologists. Study Design: A 10-year retrospective review of 2,426 OSEA from 2,223 procedures in 1,984 patients was performed. Adequacy statistics were calculated along with the accuracy of the OSEA for each OSEA provider. The effect of other variables, including the lifetime number of EUS pancreatic OSEA, the number of years of experience at the time of each case, the institutional number of EUS FNA, and the number of smears was evaluated with ANOVA. Results: There was no difference in the adequacy downgrade rate for cytotechnologists versus cytopathologists during this study period (38.2 vs. 32.2%, p = 0.13). Neither individual cytologist experience with EUS-guided pancreatic FNA (p = 0.25) nor years in practice (p = 0.86) was correlated with the accuracy of the OSEA. The experience of the institution with EUS-guided pancreatic FNA was correlated with both adequacy (p = 0.003) and accuracy (p = 0.000001). Conclusion: Cytotechnologists and cytopathologists are comparably accurate in OSEA of EUS-guided pancreatic FNA. The adequacy and accuracy of the OSEA increase with institutional experience, and this increase is not solely attributable to cytologist factors.

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Diagnostic accuracy of endoscopic ultrasound‐guided fine needle aspiration for suspected pancreatic malignancy in relation to the size of lesions

Abstract: EUS-FNA was accurate in the evaluation of suspected pancreatic malignancy regardless of its size, location, or size of needles. It was useful also in the confirmation of small pancreatic malignancies less than 10mm.

Cited by 98 publications

References 27 publications

High and low negative pressure suction techniques in EUS-guided fine-needle tissue acquisition by using 25-gauge needles: a multicenter, prospective, randomized, controlled trial

High and low negative pressure suction techniques in EUS-guided fine-needle tissue acquisition by using 25-gauge needles: a multicenter, prospective, randomized, controlled trial

Endoscopic ultrasonography with fine-needle aspiration for histological diagnosis of solid pancreatic masses: a meta-analysis of diagnostic accuracy studies

Cytotechnologist On-Site Evaluation of Pancreas Fine Needle Aspiration Adequacy: Comparison with Cytopathologists and Correlation with the Final Interpretation

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