Rapid On-Site Evaluation Reduces Needle Passes in Endoscopic Ultrasound-Guided Fine-Needle Aspiration for Solid Pancreatic Lesions: A Risk–Benefit Analysis

Schmidt, Robert L.; Walker, Brandon S; Howard, Kirsten; Layfield, Lester J.; Adler, Douglas G.

doi:10.1007/s10620-013-2750-6

Cited by 45 publications

(36 citation statements)

References 21 publications

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“…Studies have shown considerable variability in the benefits of ROSE, partly due to the adequacy rate of the sampler (i.e., the person performing the biopsy procedure) [1, 24-26]. ROSE provides little benefit when samplers have high adequacy rates [1, 27, 28], and variation in adequacy can be explained by experience [29, 30].…”

Section: Discussionmentioning

confidence: 99%

Rapid On-Site Evaluation of Fine-Needle Aspiration by Non-Cytopathologists: A Systematic Review and Meta-Analysis of Diagnostic Accuracy Studies for Adequacy Assessment

Pearson¹,

Factor²,

White³

et al. 2018

Acta Cytologica

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Objective: Rapid on-site evaluation (ROSE) has been shown to improve adequacy rates and reduce needle passes. ROSE is often performed by cytopathologists who have limited availability and may be costlier than alternatives. Several recent studies examined the use of alternative evaluators (AEs) for ROSE. A summary of this information could help inform guidelines regarding the use of AEs. The objective was to assess the accuracy of AEs compared to cytopathologists in assessing the adequacy of specimens during ROSE. Study Design: This was a systematic review and meta-analysis. Reporting and study quality were assessed using the STARD guidelines and QUADAS-2. All steps were performed independently by two evaluators. Summary estimates were obtained using the hierarchal method in Stata v14. Heterogeneity was evaluated using Higgins’ I² statistic. Results: The systematic review identified 13 studies that were included in the meta-analysis. Summary estimates of sensitivity and specificity for AEs were 97% (95% CI: 92–99%) and 83% (95% CI: 68–92%). There was wide variation in accuracy statistics between studies (I² = 0.99). Conclusions: AEs sometimes have accuracy that is close to cytopathologists. However, there is wide variability between studies, so it is not possible to provide a broad guideline regarding the use of AEs.

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Section: Discussionmentioning

confidence: 99%

Rapid On-Site Evaluation of Fine-Needle Aspiration by Non-Cytopathologists: A Systematic Review and Meta-Analysis of Diagnostic Accuracy Studies for Adequacy Assessment

Pearson¹,

Factor²,

White³

et al. 2018

Acta Cytologica

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“…There is no doubt that ROSE not only increases the overall diagnostic yield, but also effectively helps to triage the specimen for ancillary studies [40,41,42]. The value of ROSE is particularly more significant for deep-seated lymphomas than for other nonhematopoietic or superficial lesions.…”

Section: Fna Diagnosis Of Deep-seated Lymphomas Via Eus/ebus Emphasimentioning

confidence: 99%

Endoscopic/Endobronchial Ultrasound-Guided Fine Needle Aspiration and Ancillary Techniques, Particularly Flow Cytometry, in Diagnosing Deep-Seated Lymphomas

Jin

Wakely²

2016

Acta Cytologica

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Evaluation of deep-seated lymphomas by fine-needle aspiration (FNA) can be challenging due to their reduced accessibility. Controversy remains as to whether FNA and ancillary techniques can be used to diagnose deep-seated lymphomas reliably and sufficiently for clinical management. Most published studies are favorable that endobronchial ultrasound (EBUS)/endoscopic ultrasound (EUS)-FNA plays an important role in the diagnosis of deep-seated lymphomas. The addition of ancillary techniques, particularly flow cytometry, increases diagnostic yield. While subclassification is possible in a reasonable proportion of cases, the reported rates of successful subclassification are lower than those for lymphoma detection/diagnosis. The diagnostic limitation exists for Hodgkin's lymphoma, grading of follicular lymphoma, and some T-cell lymphomas. The role of FNA in deep-seated lymphomas is much better established for recurrent than primary disease. It remains unclear whether the use of large-sized-needle FNA or a combination of core needle biopsy and FNA improves subclassification. It is important for cytopathologists to have considerable understanding of the WHO lymphoma classification and develop a collaborative working relationship with hematopathologists and oncologists. As EUS/EBUS-FNA techniques advance and sophisticated molecular techniques such as next- generation sequencing become possible, the role of FNA in the diagnosis of deep-seated lymphomas will possibly increase.

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“…Multiple studies have shown that ROSE increases diagnostic yield by about 10% to 15% [7,8]. ROSE has also been shown to reduce the number of needle passes performed [9]. Due to proximity to vital structures, risk of complications such as bleeding, and time, fewer needle passes may be beneficial.…”

mentioning

confidence: 99%

Rapid on-site evaluation of cytology for EUS- and EBUS-guided fine-needle aspiration

Ramakrishna

2017

Indian J Gastroenterol

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Rapid On-Site Evaluation Reduces Needle Passes in Endoscopic Ultrasound-Guided Fine-Needle Aspiration for Solid Pancreatic Lesions: A Risk–Benefit Analysis

Abstract: Variable sampling policies using ROSE generally achieve greater per-case adequacy with fewer needle passes than non-ROSE sampling policies using a fixed number of passes.

Cited by 45 publications

References 21 publications

Rapid On-Site Evaluation of Fine-Needle Aspiration by Non-Cytopathologists: A Systematic Review and Meta-Analysis of Diagnostic Accuracy Studies for Adequacy Assessment

Rapid On-Site Evaluation of Fine-Needle Aspiration by Non-Cytopathologists: A Systematic Review and Meta-Analysis of Diagnostic Accuracy Studies for Adequacy Assessment

Endoscopic/Endobronchial Ultrasound-Guided Fine Needle Aspiration and Ancillary Techniques, Particularly Flow Cytometry, in Diagnosing Deep-Seated Lymphomas

Rapid on-site evaluation of cytology for EUS- and EBUS-guided fine-needle aspiration

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