EUS-guided FNA of solid pancreatic masses: high yield of 2 passes with combined histologic-cytologic analysis

Möller, Kathleen; Papanikolaou, Ioannis S.; Toermer, T.; Delicha, Eumorphia Maria; Sarbia, Mario; Schenck, U; Koch, Martin; Al-Abadi, H.; Meining, Alexander; Schmidt, Harald; Schulz, H.-J.; Wiedenmann, Bertram; Rösch, Thomas

doi:10.1016/j.gie.2008.10.008

Cited by 120 publications

(125 citation statements)

References 32 publications

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“…The procurement of visible core was obtained in all cases in our [4,6,10,22]. Conversely, there is one paper showing a diagnostic rate of 34% based on core biopsy with a 22G needle and five passes [23].…”

Section: Discussionmentioning

confidence: 93%

“…The sample quality for histological analysis (diagnostic cell clusters, appropriate architecture) differed between two experienced endosonographers, proving the importance of the technique in core sampling [6]. Previously, a diagnosis sensitivity rate of 60-73% by using another 22G needle [10,21,22] was obtained. Only one study used the same type of 22G FNA needle as we did, in a small number of patients; the procurement of core biopsy was 100%, but the optimal histological core was 66.7% [4].…”

Section: Discussionmentioning

confidence: 99%

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Performance of the Standard 22G Needle for Endoscopic Ultrasound-guided Tissue Core Biopsy in Pancreatic Cancer

Seicean

Gheorghiu

Zaharia

et al. 2016

JGLD

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Background & Aim: Endoscopic ultrasonography (EUS) and EUS-guided fine-needle aspiration (EUS-FNA) are considered good tools for the diagnosis of pancreatic cancer and for obtaining material for cytology or histology. The accuracy of EUS-FNA can rise to 85-95%, but it is lower in cases with a chronic pancreatitis background or with previous biliary stenting. We aimed to establish the diagnostic yield of the visible length of the core biopsy samples in pancreatic cancer by using one single type of standard 22G needle and to evaluate the factors which can influence the results. Method: EUS-FNA was performed by using a 22G standard needle on patients prospectively recruited with the suspicion of pancreatic masses on transabdominal ultrasound or CT scan over a period of eight months. The number of passes was limited by the length of the core obtained. The final diagnosis was based on EUS-FNA or hepatic biopsy for their metastasis or by follow up every three month by imaging methods. Results: The study included 118 patients. Previous stents were present in 10 patients and chronic pancreatitis features were found in 3 patients. The procedure sensitivity was 89% and the global accuracy was 89%. The presence of biliary stents did not impede the accuracy of results. The number of passes did not influence the results. Conclusions: The diagnostic rate of core biopsy by using 22G needles had a high accuracy and it is safe when the length of core dictates the number of passes. The presence of biliary stents did not influence the results. Abbreviations: AUC: area under the curve; EUS: endoscopic ultrasonography; EUS-FNA: fine needle aspiration under endosonographic guidance; FNA: fine needle aspiration; INR: international normalised ratio; OR: odds ratio.

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Performance of the Standard 22G Needle for Endoscopic Ultrasound-guided Tissue Core Biopsy in Pancreatic Cancer

Seicean

Gheorghiu

Zaharia

et al. 2016

JGLD

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“…In addition to use as a diagnostic technique, EUS-FNA has also been developed as a therapeutic means, such as for use in celiac plexus neurolysis, pseudocyst drainage, radiation therapy, the delivery of antitumor agents and bile duct drainage (35,36). The total complication rate across the reported studies concerning EUS-FNA ranges from 0 to 2.0% (37)(38)(39). With the exception of some instances of mild abdominal discomfort, no complications associated with EUS-FNA were observed in the 150 patients in the present study.…”

Section: Final Diagnosis (N) ----------------------------------------mentioning

confidence: 99%

Role of endoscopic ultrasound-guided fine needle aspiration in the diagnosis of mass lesions

Han

Lin

Zhang

et al. 2016

Experimental and Therapeutic Medicine

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Abstract. Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is an accurate technique for sampling the pancreas and mediastinum; however, limited data are available for other mass lesions. The aim of this study was to explore the value of EUS-FNA in the differential diagnosis of all mass lesions. Data from patients who underwent EUS-FNA for the diagnosis of mass lesions, including pancreatic, mediastinal, celiac and retroperitoneal lesions were retrospectively analyzed. The accuracy was calculated by comparing the results of FNA with the results of pathological examination or follow-up surveillances in non-operated cases. A total of 150 cases were included. The location of the mass varied from the pancreas (n=62) to the mediastinum (n=29), gastrointestinal tract (n=36), celiac cavity and retroperitoneum (n=23). The sensitivity and Youden ' s index of EUS-FNA in the diagnosis of all lesions were 92.97% and 0.93 respectively. The accuracy of diagnosis of pancreatic, mediastinal, gastrointestinal, celiac and retroperitoneal lesions was 85.48, 89.66, 83.33 and 78.23%, respectively. Masses were categorized into parenchymal organs (n=66), luminal organs (n=36) and enlarged lymph nodes (n=33). Lesions in parenchymal organs were likely to be bigger than those in luminal organs (P=0.03) and enlarged lymph nodes (P=0.01). For solid and cystic masses, which constituted 63.3 and 14.7% of the total masses, no significant difference in diagnostic accuracy was observed (P=0.56); however, lesion sizes were significantly different between these two groups (P=0.04) and the majority of cystic masses were identified in women (P=0.03). Malignant lesions were more common in older (P=0.01) and male (P=0.03) patients. In conclusion, EUS-FNA is an effective tool in the diagnosis of unexplained mass lesions; it influences the management of patients by enabling the appropriate treatment to be identified.

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“…EUS-FNA in diagnosis of pancreatic cancer EUS-FNA has offered new potential to EUS, as it allows for transmural tissue diagnosis with minimum invasion. EUS-FNA can therefore be extremely useful for various indications, such as suspected pancreatic cancer, diagnosis of pancreatic carcinoma, or differential diagnosis of pancreatic mass or smaller lesions [30,36,43,[53][54][55][56][57] . The indications of EUS-FNA are quite controversial, except for cases where chemotherapy or radiotherapy is needed.…”

Section: Eus or Pet In The Diagnosis Of Pancreatic Cancer?mentioning

confidence: 99%

Role of pancreatic endoscopic ultrasonography in 2010

Papanikolaou¹

2010

WJGE

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Endoscopic ultrasonography (EUS) was introduced 25 years ago aiming at better visualization of the pancreas compared to transabdominal ultrasonography. This update discusses the current evidence in 2010 concerning the role of EUS in the clinical management of patients with pancreatic disease. Major indications of EUS are: (1) Detection of common bile duct stones (e.g. in acute pancreatitis); (2) Detection of small exo-and endocrine pancreatic tumours; and (3) Performance of fine needle aspiration in pancreatic masses depending on therapeutic consequences. EUS seems to be less useful in cases of chronic pancreatitis and cystic pancreatic lesions. Moreover the constant improvement of computed tomography has limited the role of EUS in pancreatic cancer staging. On the other hand, new therapeutic options are available due to EUS, such as pancreatic cyst drainage and celiac plexus neurolysis, offering a new field in which new techniques may arise. So the main goal of this review is to determine the exact role of EUS in a number of pancreatic and biliary diseases.

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EUS-guided FNA of solid pancreatic masses: high yield of 2 passes with combined histologic-cytologic analysis

Cited by 120 publications

References 32 publications

Performance of the Standard 22G Needle for Endoscopic Ultrasound-guided Tissue Core Biopsy in Pancreatic Cancer

Performance of the Standard 22G Needle for Endoscopic Ultrasound-guided Tissue Core Biopsy in Pancreatic Cancer

Role of endoscopic ultrasound-guided fine needle aspiration in the diagnosis of mass lesions

Role of pancreatic endoscopic ultrasonography in 2010

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