Influence of On-Site Cytopathology Evaluation on the Diagnostic Accuracy of Endoscopic Ultrasound-Guided Fine Needle Aspiration (EUS-FNA) of Solid Pancreatic Masses

Iglesias‐García, Julio; Domínguez‐Muñoz, Enrique; Abdulkader, Ihab; Lariño‐Noia, José; Eugenyeva, Elena; Lozano-León, Antonio; Forteza‐Vila, Jerónimo

doi:10.1038/ajg.2011.119

Cited by 332 publications

(262 citation statements)

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“…Without on-site evaluation, the recommended number of passes is 5-7 for solid pancreatic lesions and 2-3 for lymph nodes (34,40,41). However, the on-site pathologist allows reducing the number of needle passes and increasing the diagnostic accuracy of the EUS-guided FNA (42). For pancreatic tumors, additional needles and punctures are needed in 15 % of cases, increasing the overall procedural time (9).…”

Section: Discussionmentioning

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%

“…Conventional EUS-FNA has certain limitations. Sensitivity significantly decreases by 10-15 % without an on-site pathologist to evaluate the sample obtained during the procedure (40)(41)(42). Without on-site evaluation, the recommended number of passes is 5-7 for solid pancreatic lesions and 2-3 for lymph nodes (34,40,41).…”

Section: Discussionmentioning

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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“…Reported sensitivity and accuracy for malignancy ranges from 75 to 92% and from 79 to 92%, respectively (19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33). This accuracy may be even higher using on-site evaluation of the sample by an experienced pathologist (34). Furthermore, in addition to differentiation between benign and malignant lesions, EUS-FNA can also establish the final diagnosis in many cases (33).…”

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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“…Klapman et al (10) showed that with ROSE performed by a pathologist, only 23% of aspirates had inconclusive cytological diagnosis, whereas the number of inconclusive aspirates increased to 48% when ROSE was not available. Many other studies have shown significant increase by as much as 90% in the diagnostic yield of radiologically guided FNACs with the application of ROSE by a cytopathologist (11)(12)(13)(14). In our study, the diagnostic yield of radiologically guided hepatic FNACs increased up to 95.8% when ROSE was applied (2015-2016) compared with 86.25% when ROSE was not applied (2011)(2012)(2013), which proved to be a statistically significant improvement.…”

Section: -2016mentioning

confidence: 99%

Hepatic fine-needle aspiration cytology: The role of rapid on-site evaluation in the assessment of hepatic lesions

Selhi

Tyagi

Bansal

et al. 2018

Turk J Gastroenterol

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Influence of On-Site Cytopathology Evaluation on the Diagnostic Accuracy of Endoscopic Ultrasound-Guided Fine Needle Aspiration (EUS-FNA) of Solid Pancreatic Masses

Abstract: On-site cytopathological evaluation improves the diagnostic yield of EUS-guided FNA for the cytological diagnosis of solid pancreatic masses. This is associated with a significantly lower number of inadequate samples and a lower number of needle passes.

Cited by 332 publications

References 39 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

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

Hepatic fine-needle aspiration cytology: The role of rapid on-site evaluation in the assessment of hepatic lesions

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