Endoscopic ultrasound guided fine needle aspiration for the diagnosis of intra-abdominal lymphadenopathy: a systematic review and meta-analysis

Li, Chenyu; Shuai, Yujun; Zhou, Xiaodong

doi:10.1080/00365521.2019.1704052

Cited by 14 publications

(13 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Meanwhile, several retrospective studies have analyzed the accuracy of EUS-FNA in lymphadenopathy. 24 Results from some prospective studies show that EUS-FNA is indeed sensitive for metastatic nodes, 25 which was confirmed in the current study. We posit that EUS-FNA is an adequate sampling technique when metastasis is suspected with no apparent need for a switch to EUS-FNB.…”

Section: B)supporting

confidence: 85%

“…As mentioned above, only a few prospective studies focusing on EUS-FNB have addressed the issue of lymph node metastases. Meanwhile, several retrospective studies have analyzed the accuracy of EUS-FNA in lymphadenopathy [ 24 ]. Results from some prospective studies show that EUS-FNA is indeed sensitive for metastatic nodes [ 25 ], which was confirmed in the current study.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

High Sensitivity of Endoscopic Ultrasound-Guided Fine-Needle Aspiration and Endoscopic Ultrasound-Guided Fine-Needle Biopsy in Lymphadenopathy Caused by Metastatic Disease: A Prospective Comparative Study

et al. 2021

View full text Add to dashboard Cite

Diagnosing unclear lymphadenopathy such as lymph node metastasis has an enormous impact on the treatment of neoplastic diseases. Therefore, the aim of treatment usually switches from cure to palliation. Numerous other diseases are accompanied by lymphadenopathy, including benign conditions such as infections and inflammatory disease. 1 Hence, sampling of the target node is often required to unveil the underlying diagnosis and to enable adequate clinical management. 2 Intrathoracic or intraabdominal lymphadenopathies are clinically challenging because the nodes are difficult to sample using non-invasive techniques. Therefore, invasive methods such as mediastinoscopy or laparotomy are needed but are associated with risks. 3 A mini-invasive method such as endosonography (EUS) is an alternative approach in such scenarios. 4 Endosonographic characteristics of malignant lymph nodes include large size, hypoechogenicity, distinct border, round shape, and high tissue stiffness on elastography. 5,6 Neverthe

show abstract

Section: B)supporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

High Sensitivity of Endoscopic Ultrasound-Guided Fine-Needle Aspiration and Endoscopic Ultrasound-Guided Fine-Needle Biopsy in Lymphadenopathy Caused by Metastatic Disease: A Prospective Comparative Study

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Puli et al performed a meta‐analysis and reported that the sensitivity of EUS‐FNA in diagnosing the correct etiology for solid pancreatic mass was 86.8% (95% confidence interval [CI] 85.5–87.9), and the specificity was 95.8% (95% CI 94.6–96.7) 6 . In the context of intra‐abdominal lymph nodes, Li et al performed a meta‐analysis and reported sensitivity and specificity of 94% (95% CI 91%–96%) and 98% (95% CI 96%–99%), respectively 7 . In the context of pancreatic cystic lesions, the diagnostic yield of EUS‐FNA was somewhat lower, being specific but not sensitive.…”

Section: Initial Development Of Eus‐fna and Clinical Outcome Datamentioning

confidence: 99%

The evolving role of EUS‐guided tissue acquisition

Wang

2021

J of Digest Diseases

View full text Add to dashboard Cite

The introduction of endoscopic ultrasound‐guided fine‐needle aspiration into clinical practice was a pivotal moment for diagnostic gastrointestinal endoscopy. It facilitates the ease of tissue acquisition from previously inaccessible sites. The performance characteristics of cytological diagnosis are excellent. However, there remain areas of inadequacies. These include procedural inefficiencies such as the need for rapid on‐site cytological evaluation or macroscopic on‐site evaluation, the crucial role of histology for diagnosis in specific conditions, the issue of sampling errors and the need for repeat procedures, and the shift towards personalized medicine, which requires histology, immunohistochemical studies, and molecular analysis. The original Trucut biopsy needle had been cumbersome to use, but the recent introduction of newer‐generation biopsy needles has transformed the landscape, such that there is now a greater focus on tissue acquisition for histological assessment. Concomitant technological advances of endoscopic ultrasound processors enabled higher‐resolution imaging, and facilitated image enhancement using contrast harmonic endoscopic ultrasound and endoscopic ultrasound elastography. These techniques can be used as an adjunct to guide tissue acquisition in challenging situations. There is ongoing research on the use of artificial intelligence to complement diagnostic endoscopic ultrasound and the early data are promising. Artificial intelligence may be especially important to guide clinical decision‐making if biopsy results are nondiagnostic.

show abstract

“…16 Finally, gastric cancer and pancreatic cancer with PC are most likely accompanied by lymph node metastasis; therefore, it is more likely that EUS-FNA/FNB from the lymph nodes or the primary nodule will be better for sampling. However, in our series, we would like to highlight that 1) the performance of EUS-FNA depends on many factors, including the location, size, and characteristics of the target lesion, that could make the sampling of peritoneal nodules easier; 2) despite the high sensitivity (94%) and specificity (98%) of nodal sampling, as shown in a recent meta-analysis, 17 peritoneal sampling may be a reliable and safe alternative to lymph node sampling in cases of PC of unknown origin; and 3) the certainty of the diagnosis of a primary tumor in the presence of PC obtained through peritoneal sampling represents a further instrument to complete the staging of the primary tumor and define its prognosis, thus defining the biological aggressiveness of the tumor itself.…”

Section: Discussionmentioning

confidence: 82%

Micro-Biopsy Forceps in the Assessment of Peritoneal Carcinomatosis: A Possible New Indication?

et al. 2021

View full text Add to dashboard Cite

Peritoneal carcinomatosis (PC) is defined as a metastatic involvement of the peritoneum by several other primary sites and it is characterized by a marked worsening of prognosis, with limited treatment opportunities. Subsequently, PC should be ruled out before any invasive treatment is administered. A new through-the-needle micro-biopsy forceps (MF) was recently introduced that permits micro-histology cores. In this case series, we evaluated the feasibility of MF in the assessment of PC to complete patient diagnostic work-ups. Five consecutive patients referred for endoscopic ultrasound staging were sampled using MF. Sampling was feasible in all patients with a technical success of 100%. No adverse events were reported in any cases. This technique was feasible and safe with a technical success rate of 100%. It permitted sampling of peritoneal irregularity, obtained high-quality tissue fragments in all cases, and enabled an additional assessment, i.e., immunohistochemical staining. Clin Endosc 2021 Mar 25.

show abstract

Endoscopic ultrasound guided fine needle aspiration for the diagnosis of intra-abdominal lymphadenopathy: a systematic review and meta-analysis

Cited by 14 publications

References 38 publications

High Sensitivity of Endoscopic Ultrasound-Guided Fine-Needle Aspiration and Endoscopic Ultrasound-Guided Fine-Needle Biopsy in Lymphadenopathy Caused by Metastatic Disease: A Prospective Comparative Study

High Sensitivity of Endoscopic Ultrasound-Guided Fine-Needle Aspiration and Endoscopic Ultrasound-Guided Fine-Needle Biopsy in Lymphadenopathy Caused by Metastatic Disease: A Prospective Comparative Study

The evolving role of EUS‐guided tissue acquisition

Micro-Biopsy Forceps in the Assessment of Peritoneal Carcinomatosis: A Possible New Indication?

Contact Info

Product

Resources

About