EUS-guided trucut needle biopsies in patients with solid pancreatic masses: a prospective study

Larghi, Alberto; Verna, Elizabeth C.; Stavropoulos, Stavros N.; Rotterdam, Heidrun; Lightdale, Charles J.; Stevens, Peter D.

doi:10.1016/s0016-5107(03)02538-0

Cited by 177 publications

(147 citation statements)

References 22 publications

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“…Due to the rigidity of the needle that limits the degree of the echoendoscope tip deflection required to bring the target lesion into an adequate position for puncture, the diagnostic yield of the quick-Core ® needle is strongly limited for lesions that should be punctured from the duodenum (32,35,37,38). Also, the bended scope position induces considerable friction within the needle firing mechanism that may impair its proper function.…”

Section: Discussionmentioning

confidence: 99%

“…However, there are certain drawbacks with this needle restricting its use in clinical practice. Most importantly, its diagnostic yield is strongly limited for lesions located in the head of the pancreas due to mechanical friction of the needle firing mechanism ensuing from the bended scope position (35)(36)(37)(38). Nowadays a new 19-gauge fine needle biopsy needle (ProCore TM , Cook Endoscopy Inc., Limerick, Ireland) device has been designed.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of the adequacy and diagnostic accuracy of the histology samples obtained with a newly designed 19-gauge EUS histology needle

Iglesias‐García

Abdulkader

Lariño‐Noia

et al. 2014

Rev. esp. enferm. dig.

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Background: Endoscopic ultrasound (EUS)-guided fine needle aspiration (FNA) is an accurate technique for sampling intraintestinal and extraintestinal lesions. However, cytology possesses certain limitations, which may be overcome if histological specimens are provided to the pathologist.Aim: The aim of the study was to evaluate the accuracy of a newly developed 19G histology needle.Methods: Retrospective analysis of a prospectively collected data base including patients who underwent EUS-guided biopsy with the 19G ProCore TM histology needle for the evaluation of intraintestinal or extraintestinal lesions. Samples were obtained after one needle pass, recovered into ThinPrep ® and processed for histological analysis. Results were compared to the gold standard of surgical histopathology, or global pathological, clinical and radiological assessment, and follow-up in non-operated cases. Results are shown as mean ± SD. Percentage of optimal samples for histological evaluation and the overall diagnostic accuracy were evaluated.Results: 87 patients (mean age 62.9 years, range 25-88 years, 36 woman) were included. Lesions mean size was 41.6 ± 21.3 mm. 66 lesions (75.9 %) were considered as malignant and 21 (24.1 %) as benign. EUS-guided biopsy was feasible in all cases (100 %). Sample quality was adequate for histological assessment in 82 lesions (94.2 %). In the remaining cases the sample was adequate for cell-block evaluation. Sensitivity, specificity, PPV, NPV, and overall accuracy for malignancy were 93.4 %, 100 %, 100 %, 84 %, and 95.4 %, respectively. There were no complications related to the procedure. Conclusion:The EUS-guided biopsy with the 19G histology needle provides with an optimal core sample for histological evaluation allowing a high histopathologic diagnostic accuracy.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Evaluation of the adequacy and diagnostic accuracy of the histology samples obtained with a newly designed 19-gauge EUS histology needle

Iglesias‐García

Abdulkader

Lariño‐Noia

et al. 2014

Rev. esp. enferm. dig.

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“…EUS-CNB was feasible through the transgastric route, while the transduodenal approach was successful in only 40% of cases. 170 The accuracy of EUS-CNB for the diagnosis of pancreatic malignancy has been lower (61%) than that of EUS-FNA (69%), even though all lesions were larger than 2 cm. 171 Two studies that combined EUS-FNA and EUS-CNB showed a low diagnostic yield of pancreatic EUS-CNB, but a better tissue sampling and overall diagnostic accuracy when the 2 methods were combined.…”

Section: Eus-cnbmentioning

confidence: 93%

“…EUS-CNB might also provide useful information for gene or immuno-histochemical analysis by providing a core biopsy, especially in the cases of well-differentiated tumors and tumors with substantial desmoplasia. [170][171][172][173] …”

Section: Eus-cnbmentioning

confidence: 99%

Role of endoscopic ultrasound in the diagnosis and staging of pancreatic cancer

Săftoiu

Vilmann

2008

J of Clinical Ultrasound

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Early diagnosis of pancreatic cancer remains a difficult task, and multiple imaging tests have been proposed over the years. The aim of this review is to describe the current role of endoscopic ultrasound (EUS) for the diagnosis and staging of patients with pancreatic cancer. A detailed search of MEDLINE between 1980 and 2007 was performed using the following keywords: pancreatic cancer, endoscopic ultrasound, diagnosis, and staging. References of the selected articles were also browsed and consulted. Despite progress made with other imaging methods, EUS is still considered to be superior for the detection of clinically suspected lesions, especially if the results of other cross-sectional imaging modalities are equivocal. The major advantage of EUS is the high negative predictive value that approaches 100%, indicating that the absence of a focal mass reliably excludes pancreatic cancer. The introduction of EUS-guided fine needle aspiration allows a preoperative diagnosis in patients with resectable cancer, as well as a confirmation of diagnosis before chemoradiotherapy for those that are not. This comprehensive review highlighted the diagnostic capabilities of EUS including the newest refinements such as contrast-enhanced EUS, EUS elastography, and 3-dimensional EUS. The place of EUSguided biopsy is also emphasized, including the addition of molecular marker techniques.

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“…However, there are certain drawbacks with the Quick-Core® needle that restrict its use in clinical practice. Most importantly, its diagnostic yield is strongly limited for lesions located in pancreatic head due to mechanical friction of the needle firing mechanism ensuing from the bended scope position (49)(50)(51)(52). In this setting a novel needle have been designed (Procore TM histology needle) to overcome trucut needle limitations (mainly in the second portion of the duodenum) and initial preliminary results are promising and it appears that may help solve this problem, allowing a histological evaluation with an overall accuracy of 85.9% (89.4% in pancreatic solid lesions) (53).…”

Section: Introductionmentioning

confidence: 99%

The role of endoscopic ultrasound (EUS) in relation to other imaging modalities in the differential diagnosis between mass forming chronic pancreatitis, autoimmune pancreatitis and ductal pancreatic adenocarcinoma

Iglesias‐García

Lindkvist

Lariño‐Noia³

et al. 2012

Rev. esp. enferm. dig.

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Differential diagnosis of solid pancreatic lesions remains as an important clinical challenge, mainly for the differentiation between mass forming chronic pancreatitis, autoimmune pancreatitis and pancreatic adenocarcinoma. Endoscopic ultrasound (EUS), computed tomography (CT) and magnetic resonance imaging (MRI) can all provide valuable and complementary information in this setting. Among them, EUS has the unique ability to obtain specimens for histopathological diagnosis and can therefore play a crucial role in the evaluation patients with inconclusive findings on initial examinations. Nowadays, new developed techniques associated to EUS, like elastography and contrast enhancement, have shown promising results for the differential diagnosis of these pancreatic lesions.Key words: Endoscopic ultrasound. CT scan. MRI. Pancreatic tumors. INTRODUCTIONDifferential diagnosis of solid pancreatic masses remains a challenge, despite recent advances in different diagnostic procedures. In this article, the role of endoscopic ultrasound (EUS) including EUS-guided FNA, elastography and contrast enhancement will be reviewed in relation to computer tomography (CT), magnetic resonance tomography (MRI) and magnetic resonance cholangiopancreatography (MRCP). Differential diagnosis between malignant lesions and mass-forming chronic pancreatitis or focal autoimmune pancreatitis will be discussed. Tumor staging and evaluation of resectability of these pancreatic lesions will not be evaluated. Other imaging techniques, like PET-scan or octreoscan will not be analyze, because their usefulness in this context is unclear.Differential diagnosis between malignant pancreatic lesions (pancreatic cancer, pancreatic metastasis) and massforming chronic pancreatitis CT scan is the most widely spread imaging modality for evaluation of pancreatic solid masses and considered as the most comprehensive tool for diagnosis and surgical staging of pancreatic malignancies (1). CT technology has significantly advanced over the last years, multidetector helical CT scan allows for very thin sliced cuts, providing a higher image resolution and faster image acquisition (Fig. 1) Vol. 104. N.° 6, pp. 315-321, 2012 Disclosures: Dr. Julio Iglesias-García is international advisor of Cook-Medical. Dr. J. Enrique Domínguez-Muñoz is international advisor of Pentax Medical Company.Received: 27-03-201227-03- Accepted: 20-04-2012 Correspondence: Julio Iglesias-García. Department of Gastroenterology.

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EUS-guided trucut needle biopsies in patients with solid pancreatic masses: a prospective study

Cited by 177 publications

References 22 publications

Evaluation of the adequacy and diagnostic accuracy of the histology samples obtained with a newly designed 19-gauge EUS histology needle

Evaluation of the adequacy and diagnostic accuracy of the histology samples obtained with a newly designed 19-gauge EUS histology needle

Role of endoscopic ultrasound in the diagnosis and staging of pancreatic cancer

The role of endoscopic ultrasound (EUS) in relation to other imaging modalities in the differential diagnosis between mass forming chronic pancreatitis, autoimmune pancreatitis and ductal pancreatic adenocarcinoma

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