The presence of rapid on-site evaluation did not increase the adequacy and diagnostic accuracy of endoscopic ultrasound-guided tissue acquisition of solid pancreatic lesions with core needle

2016 ◽  
Vol 31 (1) ◽  
pp. 225-230 ◽  
Author(s):  
Carlo Fabbri ◽  
Lorenzo Fuccio ◽  
Adele Fornelli ◽  
Filippo Antonini ◽  
Rosa Liotta ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Endoscopic Ultrasound ◽  
Ultrasound Guided ◽  
Core Needle ◽  
Tissue Acquisition ◽  
Site Evaluation

scholarly journals Diagnostic yield of Franseen and Fork-Tip biopsy needles for endoscopic ultrasound-guided tissue acquisition: a meta-analysis

2019 ◽  
Vol 07 (10) ◽  
pp. E1221-E1230 ◽  
Author(s):  
Antonio Facciorusso ◽  
Valentina Del Prete ◽  
Vincenzo Rosario Buccino ◽  
Purvi Purohit ◽  
Puneet Setia ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Endoscopic Ultrasound ◽  
Needle Biopsy ◽  
Diagnostic Performance ◽  
Meta Analysis ◽  
Fine Needle Biopsy ◽  
Ultrasound Guided ◽  
Fine Needle ◽  
Tissue Acquisition ◽  
Biopsy Needles

Abstract Background and study aims Although newer needle designs are thought to improve diagnostic outcomes of endoscopic ultrasound-guided fine-needle biopsy, there is limited evidence on their diagnostic performance. The aim of this meta-analysis was to provide a pooled estimate of the diagnostic performance and safety profile of Franseen and Fork-tip fine-needle biopsy needles. Patients and methods Computerized bibliographic search on the main databases was performed through March 2019. The primary endpoint was sample adequacy. Secondary outcomes were diagnostic accuracy, optimal histological core procurement, mean number of needle passes, pooled specificity and sensitivity. Safety data were also analyzed. Results Twenty-four studies with 6641 patients were included and pancreas was the prevalent location of sampled lesions. Overall sample adequacy with the two newer needles was 94.8 % (93.1 % – 96.4 %), with superiority of Franseen needle over Fork-tip (96.1 % versus 92.4 %, P < 0.001). Sample adequacy in targeting pancreatic masses was 95.6% and both needles produced results superior to fine-needle aspiration (FNA) (odds ratio 4.29, 1.49 – 12.35 and 1.79, 1.01 – 3.19 with Franseen and Fork-tip needle, respectively). The rate of histological core procurement was 92.5%, whereas diagnostic accuracy and sensitivity were 95 % and 92.8 %, again with no difference between the two needles. Number of needle passes was significantly lower in comparison to FNA (mean difference: –0.42 with Franseen and –1.60 with Fork-tip needle). No significant adverse events were registered. Conclusion Our meta-analysis speaks in favor of use of newer biopsy needles as a safe and effective tool in endoscopic ultrasound-guided tissue acquisition.

scholarly journals A269 EUS-GUIDED ROSE FNA AND CNB FOR THE DIAGNOSIS OF PANCREATIC CANCER: A COMPARATIVE ANALYSIS

2020 ◽  
Vol 3 (Supplement_1) ◽  
pp. 146-147
Author(s):  
A Almudaires ◽  
G Williams ◽  
S E Gruchy ◽  
A Morgenthau
Keyword(s):  
Pancreatic Cancer ◽  
Diagnostic Accuracy ◽  
Endoscopic Ultrasound ◽  
Diagnostic Yield ◽  
Correct Diagnosis ◽  
Needle Aspiration ◽  
Pancreatic Tumors ◽  
Ultrasound Guided ◽  
Pancreatic Lesion ◽  
Site Evaluation

Abstract Background Endoscopic ultrasound-guided fine-needle aspiration with Rapid On Site Evaluation (ROSE EUS-FNA) and endoscopic ultrasound-guided core-needle biopsy (EUS-CNB) are widely used for the diagnosis of pancreatic tumors. There is no known published randomized control trial that compares between the two modalities. Given the aggressive nature of pancreatic cancer, it is crucial to make a prompt diagnosis in order to initiate treatment in a timely fashion. Aims This study compares the diagnostic performance of ROSE EUS-FNA and EUS-CNB for diagnosis of pancreatic cancer. Methods A retrospective review was performed for patients who underwent ROSE EUS-FNA and/ or EUS-CNB for solid pancreatic lesion. Diagnostic yield (defined as percentage of diagnostic samples), diagnostic accuracy (defined as percentage of correct diagnosis), sensitivity and specificity for malignancy were compared between ROSE EUS- FNA and EUS- CNB. Baseline characteristics for both patients and lesions were also obtained. Results A total of 82 patients with solid pancreatic lesions were reviewed. 84 EUS with 61 FNA and 74 CNB were performed. The diagnostic yield was 42/61 (69%) and 59/74 (79.7%) for FNA and CNB respectively (P 0.166). The diagnostic accuracy was 33/61 (54%) and 53/74 (71%) for FNA and CNB respectively (P 0.0326). 50 patients underwent both FNA and CNB during the same EUS. The calculated diagnostic yield among this subgroup was 33/50 (66%) and 39/50 (78%) for FNA and CNB respectively (P 0.265); with diagnostic accuracy of 26/50 (52%) for FNA and 34/50 (68%) for CNB (P 0.152). The diagnostic accuracy after combining both techniques was 40/50 (80%). The incremental increase in diagnostic yield by combining both methods was 12/50 (24%) and 6/50 (12%) relative to FNA and CNB respectively. The sensitivity for the diagnosis of malignancy for FNA and CNB was 60.8% and 92.7%, respectively. The specificity was 100% for both methods. Conclusions EUS-guided CNB is a superior method of assessing solid pancreatic lesion and pancreatic malignancy with better diagnostic yield and accuracy and higher sensitivity than ROSE EUS-FNA. Funding Agencies None

Forward-viewing echoendoscope versus standard echoendoscope for endoscopic ultrasound-guided tissue acquisition of solid lesions: a randomized, multicenter study

Endoscopy ◽  
2018 ◽  
Vol 51 (05) ◽  
pp. 444-451 ◽  
Author(s):  
Alberto Larghi ◽  
Mostafa Ibrahim ◽  
Lorenzo Fuccio ◽  
Selma Lekkerkerker ◽  
Pierre Eisendrath ◽  
...  
Keyword(s):  
Gastrointestinal Tract ◽  
Diagnostic Accuracy ◽  
Endoscopic Ultrasound ◽  
Diagnostic Yield ◽  
Ultrasound Guided ◽  
Tissue Acquisition ◽  
And Performance ◽  
Subepithelial Lesions ◽  
Sensitivity Specificity ◽  
Solid Lesions

Abstract Background A forward-viewing linear (FVL) echoendoscope has been developed with the aim of overcoming some of the limitations of standard curved linear-array (CLA) echoendoscopes. There are no existing studies comparing the performance of the two echoendoscopes for endoscopic ultrasound-guided tissue acquisition (EUS-TA) of solid lesions other than subepithelial lesions. Methods This was a prospective, multicenter, randomized trial with a noninferiority design comparing FVL vs. CLA echoendoscopes in patients with solid lesions of the gastrointestinal tract or adjacent organs. Primary outcomes were successful identification of the lesion and success of EUS-TA. Secondary outcomes were safety, sensitivity, specificity, and diagnostic accuracy of the two different scopes for EUS-TA. Results 126 patients with solid lesions were randomly assigned to the CLA group (63 patients) or the FVL group (63 patients). The two groups were homogeneous with no differences in terms of needle type used, mean number of passes, and site of EUS-TA. No differences were observed between the FVL vs. CLA scopes in identification of the lesion (96.8 % vs. 98.4 %; P > 0.99) and technical success of EUS-TA (92.1 % vs. 96.8 %; P = 0.44). No adverse events occurred. Overall, diagnostic accuracy (77.8 % vs. 84.1 %), sensitivity (76.6 % vs. 84.1 %), and specificity (81.3 % vs. 84.2 %) did not differ between the two groups. Conclusions Our results strongly suggest that the FVL echoendoscope is noninferior to the CLA scope for the detection and performance of EUS-TA in patients with solid lesions of the gastrointestinal tract and adjacent organs. In addition, the FVL scope has the same diagnostic yield, accuracy, and safety as the CLA scope.

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