The best approach for sampling of pancreatic neuroendocrine tumors – EUS-FNA or EUS-FNB?

Hedenström, Per

doi:10.1055/a-0959-6138

Cited by 4 publications

(5 citation statements)

References 22 publications

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“…Another benefit of EUS is that it allows for tissue acquisition, using fine-needle aspiration for cytology or, fine-needle biopsy (FNB) with a cutting needle for histopathological diagnosis. Several studies have documented better diagnostic performance with end-cutting FNB needles, particularly for Ki67 index determination (tumour grading), which may be underestimated in fine-needle aspiration samples [ 27 , 28 ]. Preoperative knowledge of tumour grading is relevant for treatment decision, particularly in small (<2 cm) panNENs, for which tumour grading should be considered in the choice between surgery and surveillance [ 10 , 26 ].…”

Section: Pannen Stagingmentioning

confidence: 99%

“…For the detection of bone metastases, STTR-PET/CT shows a sensitivity of 97–100% and a specificity of 92–100% [ 30 ]. Notwithstanding, the potential for false-positive uptakes must be considered, particularly within the uncinate process and the pancreatic head [ 28 ]. STTR-PET/CT should also not be used in the differential diagnosis between panNENs and other hypervascular nodules, such as ectopic spleen – for characterizing pancreatic nodules detected on MRI or CT, EUS with biopsy is superior [ 10 ].…”

Section: Pannen Stagingmentioning

confidence: 99%

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Portuguese Pancreatic Club Perspectives on Pancreatic Neuroendocrine Neoplasms: Diagnosis and Staging, Associated Genetic Syndromes and Particularities of Their Clinical Approach

Ferreira-Silva,

Meireles,

Falconi

et al. 2023

GE Port J Gastroenterol

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Pancreatic neuroendocrine neoplasms (panNENs) have been historically regarded as rare, but their incidence has raised more than 6-fold over the last 3 decades, mostly owing to improvement in the detection of small asymptomatic tumours with imaging. Early detection and proper classification and staging are essential for the prognosis and management of panNENs. Histological evaluation is mandatory in all patients for the diagnosis of panNEN. Regarding localization and staging, multiphasic contrast-enhanced computer tomography is considered the imaging study of choice. Nevertheless, several other diagnostic modalities might present complementary information that can help in diagnosis and staging optimization: magnetic resonance imaging, somatostatin receptor imaging using positron emission tomography in combination with computed tomography (PET/CT), PET/CT with fluorodeoxyglucose (<sup>18</sup>F-FDG), and endoscopic ultrasound. Approximately 10% of panNENs are due to an inherited syndrome, which includes multiple endocrine neoplasia type 1, von Hippel-Lindau disease, neurofibromatosis type 1 (NF-1), tuberous sclerosis complex, and Mahvash disease. In this review, the Portuguese Pancreatic Club summarizes the classification, diagnosis, and staging of panNENs, with a focus on imaging studies. It also summarizes the characteristics and particularities of panNENs associated with inherited syndromes.

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Section: Pannen Stagingmentioning

confidence: 99%

Section: Pannen Stagingmentioning

confidence: 99%

Portuguese Pancreatic Club Perspectives on Pancreatic Neuroendocrine Neoplasms: Diagnosis and Staging, Associated Genetic Syndromes and Particularities of Their Clinical Approach

Ferreira-Silva,

Meireles,

Falconi

et al. 2023

GE Port J Gastroenterol

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“…Hijioka et al reported that the location of the tumor in the pancreatic head and the presence of rich stromal fibrosis negatively affect the sampling adequacy of EUS-FNA [ 56 ]. In recent years, fine-needle biopsy (FNB) needles have been used, which are expected to improve diagnostic ability [ 57 , 58 , 59 , 60 , 61 , 62 , 63 ].…”

Section: Role Of Eus-fna In Pnensmentioning

confidence: 99%

Role of Endoscopic Ultrasound in the Diagnosis of Pancreatic Neuroendocrine Neoplasms

et al. 2021

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Although pancreatic neuroendocrine neoplasms (PNENs) are relatively rare tumors, their number is increasing with advances in diagnostic imaging modalities. Even small lesions that are difficult to detect using computed tomography or magnetic resonance imaging can now be detected with endoscopic ultrasound (EUS). Contrast-enhanced EUS is useful, and not only diagnosis but also malignancy detection has become possible by evaluating the vascularity of tumors. Pathological diagnosis using EUS with fine-needle aspiration (EUS-FNA) is useful when diagnostic imaging is difficult. EUS-FNA can also be used to evaluate the grade of malignancy. Pooling the data of the studies that compared the PNENs grading between EUS-FNA samples and surgical specimens showed a concordance rate of 77.5% (κ-statistic = 0.65, 95% confidence interval = 0.59–0.71, p < 0.01). Stratified analysis for small tumor size (2 cm) showed that the concordance rate was 84.5% and the kappa correlation index was 0.59 (95% confidence interval = 0.43–0.74, p < 0.01). The evolution of ultrasound imaging technologies such as contrast-enhanced and elastography and the artificial intelligence that analyzes them, the evolution of needles, and genetic analysis, will further develop the diagnosis and treatment of PNENs in the future.

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“…Hijioka et al reported that the location of the tumor in the pancreatic head and the presence of rich stromal fibrosis negatively affects the sampling adequacy of EUS-FNA [38]. In recent years, fine-needle biopsy (FNB) needles have been used, which are expected to improve the diagnostic ability [39][40][41][42][43][44][45].…”

Section: Role Of Eus-fna In Pnensmentioning

confidence: 99%

Role of Endoscopic Ultrasound in the Diagnosis of Pancreatic Neuroendocrine Neoplasms

Ishii

Katanuma

Toyonaga

et al. 2020

Preprint

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The best approach for sampling of pancreatic neuroendocrine tumors – EUS-FNA or EUS-FNB?

Cited by 4 publications

References 22 publications

Portuguese Pancreatic Club Perspectives on Pancreatic Neuroendocrine Neoplasms: Diagnosis and Staging, Associated Genetic Syndromes and Particularities of Their Clinical Approach

Portuguese Pancreatic Club Perspectives on Pancreatic Neuroendocrine Neoplasms: Diagnosis and Staging, Associated Genetic Syndromes and Particularities of Their Clinical Approach

Role of Endoscopic Ultrasound in the Diagnosis of Pancreatic Neuroendocrine Neoplasms

Role of Endoscopic Ultrasound in the Diagnosis of Pancreatic Neuroendocrine Neoplasms

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