Contrast-enhanced harmonic versus standard endoscopic ultrasound-guided fine-needle aspiration in solid pancreatic lesions: a single-center prospective randomized trial

Endoscopy ◽  
2020 ◽  
Vol 52 (12) ◽  
pp. 1084-1090 ◽  
Author(s):  
Andrada Seicean ◽  
Andrada Samarghitan ◽  
Sorana D. Bolboacă ◽  
Cristina Pojoga ◽  
Ioana Rusu ◽  
...  
Keyword(s):  
Endoscopic Ultrasound ◽  
Fine Needle Aspiration ◽  
False Negative ◽  
False Negative Rate ◽  
Random Order ◽  
Needle Aspiration ◽  
Controlled Study ◽  
Surgical Specimen ◽  
Fine Needle ◽  
Contrast Enhanced

Abstract Background Contrast-enhanced harmonic endoscopic ultrasound (CH-EUS) can visualize necrotic areas and vessels inside lesions. CH-EUS findings combined with EUS-guided fine-needle aspiration (EUS-FNA) improves diagnosis in pancreatic solid masses. CH-EUS can also guide EUS-FNA (CH-EUS-FNA), potentially improving the diagnostic rate of EUS-FNA, but such superiority has not been proved in prospective studies. We aimed to assess whether CH-EUS-FNA is superior to standard EUS-FNA for specific diagnosis of solid pancreatic masses and what factors affect the diagnostic rate. Methods This randomized controlled study in one tertiary medical academic center included patients with suspected pancreatic solid masses on transabdominal ultrasound or computed tomography (CT) scan. Two passes with a 22-G standard FNA needle were done using EUS-FNA and CH-EUS-FNA in random order, and the visible core obtained was sent for histological analysis. Final diagnosis was based on EUS-FNA or surgical specimen results and on 12-month follow-up by imaging. Results 148 patients were evaluated. EUS-FNA and CH-EUS-FNA showed diagnostic sensitivities of 85.5 % and 87.6 %, respectively (not significantly different) and the combined sensitivity of the two passes was 93.8 %. The false-negative rate was not significantly different when hypoenhanced or hyperenhanced lesions were compared with the EUS-FNA results. No differences were seen for the results related to location, size, tumor stage, chronic pancreatitis features, or presence of biliary plastic stent. Conclusions The diagnostic rates for samples obtained using 22-G needles with standard EUS-FNA and CH-EUS-FNA were not statistically significantly different.

scholarly journals Diagnostic Accuracy of Fine Needle Aspiration Cytology of Thyroid Pathologies

2020 ◽  
Vol 19 (2) ◽  
pp. 84-89
Author(s):  
Shova Kunwar ◽  
Barsha Bajracharya ◽  
Kavita Karmacharya ◽  
Amar Narayan Shrestha
Keyword(s):  
Fine Needle Aspiration ◽  
Predictive Value ◽  
Fine Needle Aspiration Cytology ◽  
False Negative ◽  
False Negative Rate ◽  
Needle Aspiration ◽  
Aspiration Cytology ◽  
Thyroid Lesion ◽  
Fine Needle ◽  
Needle Aspiration Cytology

Introduction: Fine needle aspiration cytology is considered as the gold standard for the diagnosis of thyroid nodules. This study aimed to evaluate and compare the accuracy of fine-needle aspiration cytology in the diagnosis of thyroid lesion by comparing it with the corresponding histopathologic diagnosis after thyroidectomy. Methods: This is a retrospective study conducted over five years at a teaching hospital in Kathmandu. Eighty-nine cases of FNAC of thyroid nodule with subsequent histopathological reports were reviewed. The corresponding reports were compared and the accuracy of FNAC diagnosis was evaluated. Results: 87% of the cases were females and the majority of cases were in the age group 41 to 50 years. Among 89 cases, 55 were reported as benign on cytology and 34 were reported as malignant. On histopathological examination, out of 55 cases diagnosed as benign on cytology, 47 cases were diagnosed as benign whereas eight cases were diagnosed as malignant. HPE of 34 cases diagnosed as malignant on cytology showed that 29 were malignant and five were benign. The false-positive rate was 9.6% and the false-negative rate was 21.6%. The sensitivity was 78.3% and specificity was 90.3%. The positive predictive value and negative predictive value were 85.2% and 85.4% respectively. The accuracy of FNAC in differentiating benign from malignant thyroid lesions was 85.3%. Conclusions: The findings of this study showed that FNAC is a sensitive method for the diagnosis of a solid thyroid lesion

OC.01.1 THE VALUE OF CONTRAST ENHANCED ENDOSCOPIC ULTRASOUND IN THE FINE NEEDLE ASPIRATION

2016 ◽  
Vol 48 ◽  
pp. e72
Author(s):  
R. Tavani ◽  
M. Spezzaferro ◽  
A. Della Sciucca ◽  
L. Grossi ◽  
A.F. Ciccaglione ◽  
...  
Keyword(s):  
Endoscopic Ultrasound ◽  
Fine Needle Aspiration ◽  
Needle Aspiration ◽  
Fine Needle ◽  
Contrast Enhanced

Fine-needle aspiration biopsies in the management of indeterminate follicular and Hurthle cell thyroid lesions

2009 ◽  
Vol 140 (5) ◽  
pp. 715-719 ◽  
Author(s):  
Tamara Mijović ◽  
Louise Rochon ◽  
Olguta Gologan ◽  
Michael P. Hier ◽  
Martin J. Black ◽  
...  
Keyword(s):  
Fine Needle Aspiration ◽  
False Negative ◽  
False Negative Rate ◽  
Diagnostic Category ◽  
Case Series ◽  
Needle Aspiration ◽  
Fine Needle ◽  
Cytologic Atypia ◽  
Hürthle Cell ◽  
Risk Of Malignancy

Objectives: To determine the value of fine-needle aspiration biopsies (FNABs) of the thyroid and stratify the risk of malignancy within the indeterminate FNAB diagnostic category at our institution. Study design: Case series with chart review of preoperative FNABs of consecutive patients who underwent total thyroidectomy between 2005 and 2007. Subjects and Methods: A total of 115 cases were reviewed, and FNABs were categorized into four groups: benign, positive or suspicious for malignancy, indeterminate (follicular or Hurthle cell lesions), and nondiagnostic. Cytohistologic correlation was then established. Results: The accuracy of FNAB in detecting thyroid malignancy was 88 percent with false-negative and false-positive rates of 13 percent and 7 percent, respectively. Overall, 52 percent of the indeterminate cases were carcinomas (48 percent of follicular lesions and 62 percent of Hurthle cell lesions). In the presence of cytologic atypia, the rate of malignancy increased to 75 percent and 83 percent for the follicular and Hurthle cell lesions, respectively. Conclusions: FNAB is an accurate and helpful method for the evaluation of thyroid nodules with results directly correlating with management. Surgery should be considered for FNABs categorized as indeterminate, especially in the presence of cytologic atypia. Because of the high false-negative rate, benign FNABs require close follow-up with ultrasound examination and periodic biopsies.

scholarly journals Performance of endoscopic ultrasound-guided fine needle aspiration in diagnosing pancreatic neuroendocrine tumors

CytoJournal ◽  
2013 ◽  
Vol 10 ◽  
pp. 10 ◽  
Author(s):  
Jane Bernstein ◽  
Berrin Ustun ◽  
Ahmed Alomari ◽  
Fang Bao ◽  
Harry R. Aslanian ◽  
...  
Keyword(s):  
Neuroendocrine Tumors ◽  
Endoscopic Ultrasound ◽  
Fine Needle Aspiration ◽  
False Negative ◽  
Needle Aspiration ◽  
Cystic Neoplasm ◽  
Pancreatic Neuroendocrine Tumors ◽  
Ultrasound Guided ◽  
Fine Needle

Background: Pancreatic neuroendocrine tumors (PNETs) are rare tumors of the pancreas, which are increasingly diagnosed by endoscopic ultrasound-guided fine needle aspiration (EUS-FNA). In this retrospective study, we assessed the performance of EUS-FNA in diagnosing PNETs. Materials and Methods: We identified 48 cases of surgically resected PNETs in which pre-operative EUS-FNA was performed. The clinical features, cytological diagnoses, and surgical follow-up were retrospectively reviewed. The diagnostic performance of EUS-FNA was analyzed as compared to the diagnosis in the follow-up. The cases with discrepancies between cytological diagnosis and surgical follow-up were analyzed and diagnostic pitfalls in discrepant cases were discussed. Results: The patients were 20 male and 28 female with ages ranging from 15 years to 81 years (mean 57 years). The tumors were solid and cystic in 41 and 7 cases, respectively, with sizes ranging from 0.5 cm to 11 cm (mean 2.7 cm). Based on cytomorphologic features and adjunct immunocytochemistry results, when performed, 38 patients (79%) were diagnosed with PNET, while a diagnosis of suspicious for PNET or a diagnosis of neoplasm with differential diagnosis including PNET was rendered in the 3 patients (6%). One case was diagnosed as mucinous cystic neoplasm (2%). The remaining 6 patients (13%) had non-diagnostic, negative or atypical diagnosis. Conclusions: Our data demonstrated that EUS-FNA has a relatively high sensitivity for diagnosing PNETs. Lack of additional materials for immunocytochemical studies could lead to a less definite diagnosis. Non-diagnostic or false negative FNA diagnosis can be seen in a limited number of cases, especially in those small sized tumors.

Mo1451 The Contrast Enhanced Endoscopic Ultrasound Increases the Diagnostic Accuracy of the Fine Needle Aspiration in Pancreatic Masses

2014 ◽  
Vol 79 (5) ◽  
pp. AB442
Author(s):  
Andrada Seicean ◽  
A.N.C.A. Moldovan-Pop ◽  
Adrian Saftoiu ◽  
Costin T. Streba ◽  
Simona Vultur ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Endoscopic Ultrasound ◽  
Fine Needle Aspiration ◽  
Needle Aspiration ◽  
Fine Needle ◽  
Contrast Enhanced ◽  
Pancreatic Masses

Evaluation of Pancreatic Lesions With Endoscopic Ultrasound and Fine Needle Aspiration

2020 ◽  
pp. 155335062092532
Author(s):  
Yan Luk ◽  
Wong Hoi She ◽  
Felix Che Lok Chow ◽  
Ka Wing Ma ◽  
Simon Hing Yin Tsang ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Endoscopic Ultrasound ◽  
Fine Needle Aspiration ◽  
Predictive Value ◽  
Diagnostic Yield ◽  
False Negative ◽  
Needle Aspiration ◽  
Pancreatic Lesion ◽  
Fine Needle ◽  
Histopathological Findings

Background. Endoscopic ultrasound (EUS) and fine-needle aspiration (FNA) are commonly used for assessing pancreatic lesions. This study aimed to evaluate the diagnostic yield and accuracy of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) in a single tertiary institution. Methods. Consecutive patients who underwent EUS-FNA of the pancreas at Queen Mary Hospital, Hong Kong, from January 2015 to March 2016 were retrospectively reviewed. Endoscopic findings and FNA results were analysed. For patients who subsequently underwent surgical resection of pancreatic lesion, EUS-FNA diagnoses were compared to histopathological findings of surgical specimens to determine its diagnostic accuracy. Results. One hundred twelve EUS-FNA were performed in 99 patients within the study time period and were included for analysis. Sixty-six (66.7%) pancreatic lesions were solid in nature and 33 (33.3%) were cystic. The overall diagnostic yield of EUS-FNA was 70.5% (n = 79). On multivariate analysis, more passes of needle were associated with a higher diagnostic yield (odds ratio = 2.000, P = .049). 57.1% (n = 64) of EUS-FNA results had an impact on management. Sixteen patients with diagnostic EUS-FNA subsequently underwent surgery for resection of the pancreatic lesion. Upon correlation to the histopathological findings of surgical specimens, there were 12 true-positive, 2 true-negative, 0 false-positive, and 2 false-negative cases. Sensitivity was 85.7%, specificity was 100%, positive predictive value was 100%, and negative predictive value was 50%. The diagnostic accuracy of EUS-FNA was 87.5%. Conclusion. EUS-FNA is accurate and reliable for diagnosing pancreatic lesions.

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