Does ProCore fine needle biopsy really improve the clinical outcome of endoscopic ultrasound-guided sampling of pancreatic masses?

2021 ◽  
Author(s):  
Gabriele Delconte ◽  
Federica Cavalcoli ◽  
Andrea Magarotto ◽  
Giovanni Centonze ◽  
Cristina Bezzio ◽  
...  
Keyword(s):  
Adverse Events ◽  
Diagnostic Accuracy ◽  
Likelihood Ratio ◽  
Endoscopic Ultrasound ◽  
Needle Biopsy ◽  
Clinical Performance ◽  
Negative Likelihood Ratio ◽  
Fine Needle Biopsy ◽  
Fine Needle ◽  
Sensitivity Specificity

Introduction: Fine Needle Biopsy (FNB) has been suggested to provide better histological samples as compared to endoscopic ultrasound fine needle aspiration (EUS-FNA). However, studies comparing EUS-FNA and EUS-FNB for pancreatic lesions reported contrasting results. The aim of this study was to compare the clinical performance of EUS-FNA versus EUS-FNB with ProCore needle for the investigation of pancreatic lesions. Methods: We reviewed all patients undergoing EUS for the investigation of pancreatic lesions from August 2012 to September 2018. From August 2012 to January 2015 all procedures were performed with standard needles, whereas from February 2015 to September 2018 the use of ProCore needles had been introduced. Data on diagnostic accuracy, number of needle passes and/or adverse events were collected. Results: 324 patients were retrospectively evaluated: 190 (58.6%) underwent EUS-FNA and 134 (41.4%) EUS-FNB. Both EUS-FNA and EUS-FNB showed high diagnostic accuracy for malignancy [94% (CI 95%:89-97%) vs 94% (CI 95%:89-98%)]. Notable, there were no differences between EUS-FNA and EUS-FNB in terms of sensitivity, specificity, positive and negative likelihood ratio, histological core tissue retrieval, adverse events or number of needle passes. However, subgroup analysis noted a higher diagnostic accuracy for 25G EUS-FNB as compared to 25G EUS-FNA (85,7% vs 55,5%; *p=0.023). Conclusion: EUS-FNB with ProCore needle is safe and feasible in pancreatic lesions. ProCore needle did not provide any advantage in terms of diagnostic accuracy, sensitivity, specificity, positive and/or negative likelihood ratio, or acquisition of core specimen, therefore its routine application is not

scholarly journals Endoscopic Ultrasound Fine-Needle Biopsy versus Fine-Needle Aspiration for Tissue Sampling of Abdominal Lymph Nodes: A Propensity Score Matched Multicenter Comparative Study

Cancers ◽  
2021 ◽  
Vol 13 (17) ◽  
pp. 4298
Author(s):  
Antonio Facciorusso ◽  
Stefano Francesco Crinò ◽  
Nicola Muscatiello ◽  
Paraskevas Gkolfakis ◽  
Jayanta Samanta ◽  
...  
Keyword(s):  
Propensity Score ◽  
Adverse Events ◽  
Diagnostic Accuracy ◽  
Endoscopic Ultrasound ◽  
Fine Needle Aspiration ◽  
Needle Biopsy ◽  
Fine Needle Biopsy ◽  
Needle Aspiration ◽  
Tissue Sampling ◽  
Fine Needle

There is a paucity of evidence on the comparison between endoscopic ultrasound (EUS) fine-needle biopsy (FNB) and fine-needle aspiration (FNA) for lymph node (LNs) sampling. The aim of this study was to compare these two approaches in a multicenter series of patients with abdominal tumors. Out of 502 patients undergoing EUS sampling, two groups following propensity score matching were compared: 105 undergoing EUS-FNB and 105 undergoing EUS-FNA. The primary outcome was diagnostic accuracy. Secondary outcomes were diagnostic sensitivity, specificity, sample adequacy, optimal histological core procurement, number of passes, and adverse events. Median age was 64.6 years, and most patients were male in both groups. Final diagnosis was LN metastasis (mainly from colorectal cancer) in 70.4% of patients in the EUS-FNB group and 66.6% in the EUS-FNA group (p = 0.22). Diagnostic accuracy was significantly higher in the EUS-FNB group as compared to the EUS-FNA group (87.62% versus 75.24%, p = 0.02). EUS-FNB outperformed EUS-FNA also in terms of diagnostic sensitivity (84.71% vs. 70.11%; p = 0.01), whereas specificity was 100% in both groups (p = 0.6). Sample adequacy analysis showed a non-significant trend in favor of EUS-FNB (96.1% versus 89.5%, p = 0.06) whereas the histological core procurement rate was significantly higher with EUS-FNB (94.2% versus 51.4%; p < 0.001). No procedure-related adverse events were observed. These findings show that EUS-FNB is superior to EUS-FNA in tissue sampling of abdominal LNs.

scholarly journals Use of suction during endoscopic ultrasound-guided fine needle biopsy of solid pancreatic lesions with a Franseen-tip needle: a pilot comparative trial

2021 ◽  
Vol 09 (03) ◽  
pp. E401-E408
Author(s):  
Pedro Costa-Moreira ◽  
Filipe Vilas-Boas ◽  
Diana Martins ◽  
Pedro Moutinho-Ribeiro ◽  
Susana Lopes ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Likelihood Ratio ◽  
Endoscopic Ultrasound ◽  
Needle Biopsy ◽  
Diagnostic Yield ◽  
Fine Needle Biopsy ◽  
Blood Contamination ◽  
Fine Needle ◽  
Significant Difference ◽  
The Impact

Abstract Background and study aims The utility of suction during endoscopic ultrasound (EUS) fine-needle biopsy (FNB) using Franseen-tip needle remains unclear and has not been evaluated in randomized trials. We designed a randomized crossover trial to compare the diagnostic yield during EUS-FNB using a 22G Franseen-tip needle, with and without standard suction. Patients and methods Consecutive patients undergoing EUS-guided sampling of solid pancreatic lesions were recruited. A minimum of two passes were performed for each case: one with 20-mL syringe suction (S+) and another without (S–). The order of passes was randomized and the pathologist blinded. The endpoints were the diagnostic yield and the impact of blood contamination in the diagnosis. Results Fifty consecutive patients were enrolled. The overall diagnostic accuracy was 84 %. A diagnosis of malignancy was obtained in 70 samples: 36 in the S+group and 34 in the S–group. A statistically significant difference was seen in the diagnostic accuracy (S+: 78 % vs. S–: 72 %, P < 0.01) and blood contamination (S+: 68 %; S–: 44 %, P < 0.01). The sensitivity, specificity, negative likelihood ratio and positive likelihood ratio for S+vs. S–samples were 76.6 % vs. 73.9 %, 100 % vs. 100 % and 0.23 vs. 0.26, NA vs NA, respectively. A negative impact of blood contamination in the overall diagnostic yield wasn’t seen, even in samples where suction was used (OR 0.36, P = 0.15) Conclusions We found a higher diagnostic yield with the use of suction. It was associated with a higher degree of sample blood contamination that did not affect the diagnostic performance.

scholarly journals Su1297 ENDOSCOPIC ULTRASOUND-GUIDED FINE NEEDLE BIOPSY: DIAGNOSTIC ACCURACY OF CYTOLOGY AND HISTOLOGY

2020 ◽  
Vol 91 (6) ◽  
pp. AB319
Author(s):  
Liza Plafsky ◽  
Tara Keihanian ◽  
Jinendra L. Satiya ◽  
Liege I. Diaz ◽  
Mohit Girotra
Keyword(s):  
Diagnostic Accuracy ◽  
Endoscopic Ultrasound ◽  
Needle Biopsy ◽  
Fine Needle Biopsy ◽  
Ultrasound Guided ◽  
Fine Needle

scholarly journals A Comparison of Endoscopic Ultrasound-Guided Fine-Needle Aspiration and Fine-Needle Biopsy in the Diagnosis of Solid Pancreatic Lesions

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Lachlan R. Ayres ◽  
Elizabeth K. Kmiotek ◽  
Eric Lam ◽  
Jennifer J. Telford
Keyword(s):  
Diagnostic Accuracy ◽  
Endoscopic Ultrasound ◽  
Fine Needle Aspiration ◽  
Needle Biopsy ◽  
Diagnostic Performance ◽  
Fine Needle Biopsy ◽  
Needle Aspiration ◽  
True Positive ◽  
Ultrasound Guided ◽  
Fine Needle

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.

scholarly journals Macroscopic onsite evaluation using endoscopic ultrasound fine needle biopsy as an alternative to rapid onsite evaluation

2019 ◽  
Vol 07 (02) ◽  
pp. E189-E194 ◽  
Author(s):  
En-Ling Leung Ki ◽  
Anne-Isabelle Lemaistre ◽  
Fabien Fumex ◽  
Rodica Gincul ◽  
Christine Lefort ◽  
...  
Keyword(s):  
Endoscopic Ultrasound ◽  
Predictive Value ◽  
Needle Biopsy ◽  
Final Diagnosis ◽  
Fine Needle Biopsy ◽  
Fine Needle ◽  
Tissue Acquisition ◽  
Site Evaluation ◽  
Sensitivity Specificity ◽  
Solid Lesions

Abstract Background and aims This study aimed to evaluate the performance of Macroscopic On-site Evaluation (MOSE) using a novel endoscopic ultrasound (EUS) fine needle biopsy (FNB) needle (22-G Franseen-tip needle, Acquire, Boston Scientific Incorporated, Boston, Massachusetts, United States), and without using Rapid On-Site Evaluation (ROSE). Method Between May 2016 and August 2016, all consecutive patients referred to our center for EUS tissue acquisition (TA) for solid lesions underwent EUS-FNB with the 22-G Franseen-tip needle unless contra-indicated. The operator performed MOSE. If no macroscopic core was visualized, a second pass was performed. The final diagnosis was defined as unequivocal histology from EUS-TA with compatible 18 months follow-up, surgical resection, or both. We retrospectively analyzed the performance of MOSE. Results A total of 46 consecutive patients was included, and 54 solid lesions were biopsied. The endosonographer visualized core tissue in 93 % (50/54) of targets with a single pass, of which the pathologist confirmed histologic core fragments in 94 % (47/50). Four lesions required two passes, and the overall correlation between MOSE and histologic core fragments was 94 % (48/51). Diagnostic adequacy was 98 % (53/54) with one biliary target biopsied without significant material. The overall diagnostic accuracy was 94 %. Sensitivity, specificity, positive predictive value, and negative predictive value for malignancy were 92 %, 100 %, 100 %, and 81 %, respectively. No adverse events were reported. Conclusion Our study demonstrated that MOSE using the 22-G Franseen-tip needle could limit needle passes by accurately estimating histologic core fragments. It also demonstrated that high diagnostic adequacy and accuracy of > 90 % could be achieved without ROSE.

scholarly journals Clinical Impact of EUS-Guided Fine Needle Biopsy Using a Novel Franseen Needle for Histological Assessment of Pancreatic Diseases

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Takuya Ishikawa ◽  
Hiroki Kawashima ◽  
Eizaburo Ohno ◽  
Hiroyuki Tanaka ◽  
Daisuke Sakai ◽  
...  
Keyword(s):  
Adverse Events ◽  
Diagnostic Accuracy ◽  
Needle Biopsy ◽  
Fine Needle Biopsy ◽  
Pancreatic Diseases ◽  
Fine Needle ◽  
Histological Assessment ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background and Aims. Several studies have shown the benefits of endoscopic ultrasound-guided fine needle biopsy (EUS-FNB) using a Franseen needle for histological assessment. However, studies focusing on pancreatic diseases are limited and the safety of this method has not been well assessed. We aimed to assess the current status and issues of EUS-FNB in the diagnosis of pancreatic diseases. Materials and Methods. We retrospectively reviewed 87 consecutive EUS-FNB specimens using either a 22-gauge Franseen needle (Group A, N = 51) or a conventional 22-gauge fine-needle aspiration needle (Group B, N = 36) for pancreatic diseases, and the diagnostic accuracy and safety were compared. Final diagnoses were obtained based on surgical pathology or a minimum six-month clinical follow-up. Results. Although the diagnostic accuracy for malignancy was 96.1% in Group A versus 88.9% in Group B, with no statistically significant difference (P = 0.19), the median sample area was significantly larger in Group A (4.07 versus 1.31mm2, P < 0.0001). There were no differences between the two needles in the locations from which the specimens were obtained. Adverse events occurred in one case (2%) in Group A (mild pancreatitis) and none in Group B with no statistical significance (P = 0.586). Although there was no case of bleeding defined as adverse events, 2 cases in Group A showed active bleeding during the procedure with increase in the echo-free space, which required CT scanning to rule out extravasation. Eventually, the bleeding stopped spontaneously. Conclusions. Given its guaranteed ability to obtain core specimens and comparable safety, and although the risk of bleeding should be kept in mind, EUS-FNB using a Franseen needle is likely to become a standard procedure for obtaining pancreatic tissue in the near future.

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.

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