Endoscopic ultrasound-guided fine-needle aspiration and fine-needle biopsy for solid lesions: Does a “belt and suspenders” approach add value?

Background and Aims. Endoscopic ultrasound (EUS) guided fine-needle aspiration (FNA) is the method of choice for sampling pancreatic lesions. This study compares the diagnostic accuracy and safety of FNB using a novel core needle to FNA in solid pancreatic lesions. Methods. A retrospective review of patients in whom EUS FNA or FNB was performed for solid pancreatic lesions was conducted. Diagnostic performance was calculated based upon a dual classification system: classification 1, only malignant pathology considered a true positive, versus classification 2, atypical, suspicious, and malignant pathology considered a true positive. Results. 43 patients underwent FNB compared with 51 FNA. Using classification 1, sensitivity was 74.0% versus 80.0%, specificity 100% versus 100%, and diagnostic accuracy 77.0% versus 80.0% for FNB versus FNA, respectively (all p>0.05). Using classification 2, sensitivity was 97% versus 94.0%, specificity 100% versus 100%, and diagnostic accuracy 98.0% versus 94.0% for FNB versus FNA, respectively (all p>0.05). FNB required significantly fewer needle passes (median = 2) compared to FNA (median = 3; p<0.001). Adverse events occurred in two (4.5%) FNB patients compared with none in the FNA group (p>0.05). Conclusion. FNA and FNB have comparable sensitivity and diagnostic accuracy. FNB required fewer passes.

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Endoscopic ultrasound-guided sampling of solid pancreatic masses: the fine needle aspiration or fine needle biopsy dilemma. Is the best needle yet to come?

World Journal of Gastrointestinal Endoscopy ◽

10.4253/wjge.v11.i8.000 ◽

2019 ◽

Vol 11 (8) ◽

pp. 454-471

Author(s):

Clara Benedetta Conti ◽

Fabrizio Cereatti ◽

Roberto Grassia

Keyword(s):

Endoscopic Ultrasound ◽

Fine Needle Aspiration ◽

Needle Biopsy ◽

Fine Needle Biopsy ◽

Needle Aspiration ◽

Ultrasound Guided ◽

Fine Needle ◽

Pancreatic Masses ◽

To Come

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Su1295 ENDOSCOPIC ULTRASOUND FINE NEEDLE ASPIRATION VERSUS FINE NEEDLE BIOPSY IN SOLID LESIONS: A MULTI-CENTER ANALYSIS

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2020.03.2141 ◽

2020 ◽

Vol 91 (6) ◽

pp. AB317-AB318

Author(s):

Diogo T. de Moura ◽

Thomas R. McCarty ◽

Pichamol Jirapinyo ◽

Igor B. Ribeiro ◽

Galileu F. Farias ◽

...

Keyword(s):

Endoscopic Ultrasound ◽

Fine Needle Aspiration ◽

Needle Biopsy ◽

Fine Needle Biopsy ◽

Needle Aspiration ◽

Fine Needle ◽

Solid Lesions

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Endoscopic ultrasound-guided fine-needle biopsy is superior to fine-needle aspiration in assessing pancreatic neuroendocrine tumors

Endoscopy International Open ◽

10.1055/a-0990-9611 ◽

2019 ◽

Vol 07 (10) ◽

pp. E1281-E1287 ◽

Cited By ~ 4

Author(s):

John S Leeds ◽

Manu K. Nayar ◽

Noor L.H. Bekkali ◽

Colin H. Wilson ◽

Sarah J. Johnson ◽

...

Keyword(s):

Surgical Resection ◽

Fine Needle Aspiration ◽

Needle Biopsy ◽

Tumor Grade ◽

Fine Needle Biopsy ◽

Needle Aspiration ◽

Pancreatic Neuroendocrine Tumors ◽

Ultrasound Guided ◽

Fine Needle ◽

Solid Lesions

Abstract Background and study aims Pancreatic neuroendocrine tumors (PanNETs) outcomes are dependent upon grading by Ki67. This study compared endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) to fine-needle aspiration (FNA) in assessing PanNETs. Patients and methods All pancreatic histology for PanNET between January 2009 and June 2017 was included if EUS sampling was performed prior to surgical resection. Ki67 and grade from FNA and FNB samples was compared to surgical histology using correlation coefficient and kappa values. Subgroup analysis was performed for purely solid lesions, lesions < 2 cm and FNB needle type. Results One hundred sixity-four patients had PanNET of which 57 underwent surgical resection. Thirty-five lesions underwent FNA and 26 FNB (4 had both) confirming PanNET. 23/ of 35 FNA samples reported Ki67/grading compared to all 26 FNB samples (P = 0.0006). Compared to surgical histology, Ki67 on FNA correlated poorly overall (r = –0.08), in solid lesions (r = –0.102) and lesions < 2 cm (r = –0.149) whereas FNB correlated moderately overall (r = 0.65), in solid lesions (r = 0.64) and lesions < 2 cm (r = 0.61). Tumor grade showed poor agreement (kappa) with FNA overall (0.026), in solid lesions (0.044) and lesions < 2 cm (0.00) whereas FNB showed moderate-good agreement overall (0.474), in solid lesions (0.58) and lesions < 2 cm (0.745). Fork-tip FNB needles Ki67 showed strong correlation with surgical histology (r = 0.788) compared to reverse bevel FNB needles (r = 0.521). Both FNB needles showed moderate agreement with tumor grade. Conclusion FNB samples were significantly more likely than FNA to provide adequate material for Ki67/grading and showed a closer match to surgical histology. FNB needle types require prospective investigation.

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