The role of rapid on‐site evaluation on diagnostic accuracy of endoscopic ultrasound fine needle aspiration for pancreatic, submucosal upper gastrointestinal tract and adjacent lesions

Abstract

Background and Aim Our aim was to assess adequacy and diagnostic accuracy of endoscopic ultrasound‐fine needle aspiration (EUS‐FNA) specimens with or without rapid on‐site evaluation (ROSE) from pancreatic, upper gastrointestinal tract (UGIT) and adjacent masses. Method A retrospective cohort study based on patients’ files who underwent EUS‐FNA in Galilee Medical Center in a 4 years period. Number of needle passes, repeated EUS and ROSE effect on tissue adequacy and diagnostic accuracy were reported. Results One‐hundred sixty‐one patients were included. Ninety‐three patients (57.7%) underwent EUS‐FNA without ROSE (group A) compared to 68 patients (42.3%) with ROSE (group B). The most common location was in the pancreas (55% in group A vs 81% in group B). Addition of ROSE yielded a significantly higher specimen adequacy (65% in group A vs 92.6% in group B (Chi‐Square < 0.0001, OR 6.72, 95% CI 2.45‐18.38). The matching rate (accuracy) between ROSE diagnosis and final histopathological diagnosis was noticed in 61 out of 68 patients (89.7%, 95% CI 0.7993‐0.9576). The Kappa coefficient correlations of matching rate between ROSE and final histopathological diagnosis of all lesion and in pancreatic lesions were 0.7558, (95% CI 0.625‐0.887) and 0.7814, (95% CI 0.639‐0.924), respectively. Conclusions EUS‐FNA with ROSE significantly improve specimen adequacy and was associated with high diagnostic accuracy.

Deep Learning-Based Ultrasound Combined with Gastroscope for the Diagnosis and Nursing of Upper Gastrointestinal Submucous Lesions

“…The results showed that leiomyomas in the esophagus were significantly more than cysts, and leiomyomas in the upper esophagus were significantly less than those in the middle and lower esophagus, and the difference was statistically significant ( P < 0.05). There were more stromal tumors in the bottom and body of the stomach than in other parts, and the ectopic pancreas in the antrum was significantly more than that in other parts, and the difference was statistically significant ( P < 0.05), which was consistent with the result of Khoury et al [ 28 ]. At last, the study compared the diagnostic effects of ultrasound combined with gastroscope on upper gastrointestinal submucous occasions.…”

Factors influencing diagnostic accuracy of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) in pancreatic and biliary tumors

“…Guidelines released by the European Society of Gastrointestinal Endoscopy (ESGE) recommend a minimum of 20 to 30 supervised EUS-FNAs in the presence of rapid onsite cytopathological examination (ROSE) to reach sufficient competency in this technique and sensitivity for pathological diagnosis up to 80% [21]. The importance of ROSE in increasing EUS-FNA diagnostic accuracy and reducing the number of passes needed to obtain sufficient tissue specimens is largely debated [22]. However, the presence of a cytopathologist in the endoscopy room may be limited for a number of practical reasons, such as local availability and high costs.…”

Advancements in the Diagnosis of Gastric Subepithelial Tumors

“…Massive studies have already been published regarding the diagnostic yield of EUS-FNAB. 22 - 56 A meta-analysis published in 2016 reports that EUS-guided sampling of upper gastrointestinal subepithelial lesions is safe, but has a moderate diagnostic ability (59.9%) regardless of techniques of FNA/FNB/Tru-Cut needle biopsy or the needle diameter used for puncture. 57 Conversely, a successive meta-analysis reveals that sampling ability of FNA (80.6%) is significantly lower to that of FNB (94.9%), but increase with the help of rapid on-site evaluation.…”