scholarly journals The Effect of a Pathologists Experience on Sample Adequacy in Endoscopic Ultrasonography-Guided Fine Needle Aspiration (EUS- FNA): Another Factor to Consider?

2020 ◽  
Vol I (1) ◽  
pp. 11-16
Author(s):  
Shruti Mony
Keyword(s):  
Endoscopic Ultrasonography ◽  
Fine Needle Aspiration ◽  
Diagnostic Yield ◽  
Needle Aspiration ◽  
Years Of Experience ◽  
Gastrointestinal Malignancies ◽  
Fine Needle ◽  
Pancreatic Masses ◽  
The Mean ◽  
Number Of Passes

Background Endoscopic Ultrasonography-guided Fine Needle Aspiration (EUS-FNA), which is the preferred method for sampling gastrointestinal malignancies, is dependent on multiple factors. We aimed to evaluate if the experience of the on-site pathologist had an effect on the sample adequacy and tissue yield. Methods A single center, retrospective cohort study was conducted among patients undergoing EUS-FNA between 2015 to 2018 for solid GI lesions. Sample adequacy, pathologist experience, needle passes, size and cytological diagnosis was collected. On-site pathologist reported the sample adequacy. Results A total of 163 patients (47.2% male), median age 68 years, with solid GI lesions (79.8% pancreatic masses), were included. There was no significant correlation between the experience of pathologists and the number of EUS-FNA passes required to attain sample adequacy(r =0.158, p= 0.078). The mean number of passes to attain adequacy was not statistically significant between pathologists with <=10 years of experience versus those with >10 years of experience (1.94 vs. 1.97 passes). However, more experienced pathologists requested a greater number of EUS-FNA passes for an adequate sample compared to less experienced pathologists (4.05 vs. 3.23; p=0.003). Conclusions While there was no difference in determining sample adequacy based on pathologist experience, the experienced pathologists actually requested more FNA passes than less experienced ones. One rationale is that younger graduates have better exposure to EUS-FNA, leading to a greater level of confidence with securing a diagnosis. Further data is required to evaluate this effect. Keywords: Endoscopic Ultrasound; Pathologist Experience; Fine Needle Aspiration; Sample Adequacy; Diagnostic Yield.

scholarly journals Diagnostic yield of endoscopic ultrasound-guided biopsy of focal liver lesions

2019 ◽  
Vol 92 (1) ◽  
pp. 15-20 ◽  
Author(s):  
Vlad Andrei Ichim ◽  
Romeo Ioan Chira ◽  
Petru Adrian Mircea
Keyword(s):  
Endoscopic Ultrasonography ◽  
Endoscopic Ultrasound ◽  
Fine Needle Aspiration ◽  
Diagnostic Yield ◽  
Needle Aspiration ◽  
Focal Liver Lesions ◽  
Liver Lesions ◽  
Ultrasound Guided ◽  
Clinical Role ◽  
Fine Needle

Endoscopic ultrasonography (EUS) has become an indispensable method for diagnosis and therapeutic procedures in gastroenterology. As experience with this technique grows, new indications continue to emerge. Due to the vicinity of the transducer to the liver, endoscopic ultrasonography provides detailed images of the liver segments and its vascular and biliary structures. Endosonographers have made an effort to define a clinical role for endoscopic ultrasound in liver diseases; however, not much is known about endoscopic ultrasound guided fine needle aspiration (EUS-FNA) in hepatic focal lesions. This review summarizes the available evidence regarding the usefulness of endoscopic ultrasound-guided fine needle aspiration in patients with focal liver lesions.  

Performance of the Standard 22G Needle for Endoscopic Ultrasound-guided Tissue Core Biopsy in Pancreatic Cancer

2016 ◽  
Vol 25 (2) ◽  
pp. 213-218 ◽  
Author(s):  
Andrada Seicean ◽  
Marcel Gheorghiu ◽  
Teodor Zaharia ◽  
Tudor Calinici ◽  
Andrada Samarghitan ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Chronic Pancreatitis ◽  
Endoscopic Ultrasonography ◽  
Fine Needle Aspiration ◽  
Core Biopsy ◽  
Needle Aspiration ◽  
Biliary Stents ◽  
Fine Needle ◽  
The Core ◽  
Number Of Passes

Background & Aim: Endoscopic ultrasonography (EUS) and EUS-guided fine-needle aspiration (EUS-FNA) are considered good tools for the diagnosis of pancreatic cancer and for obtaining material for cytology or histology. The accuracy of EUS-FNA can rise to 85-95%, but it is lower in cases with a chronic pancreatitis background or with previous biliary stenting. We aimed to establish the diagnostic yield of the visible length of the core biopsy samples in pancreatic cancer by using one single type of standard 22G needle and to evaluate the factors which can influence the results. Method: EUS-FNA was performed by using a 22G standard needle on patients prospectively recruited with the suspicion of pancreatic masses on transabdominal ultrasound or CT scan over a period of eight months. The number of passes was limited by the length of the core obtained. The final diagnosis was based on EUS-FNA or hepatic biopsy for their metastasis or by follow up every three month by imaging methods. Results: The study included 118 patients. Previous stents were present in 10 patients and chronic pancreatitis features were found in 3 patients. The procedure sensitivity was 89% and the global accuracy was 89%. The presence of biliary stents did not impede the accuracy of results. The number of passes did not influence the results. Conclusions: The diagnostic rate of core biopsy by using 22G needles had a high accuracy and it is safe when the length of core dictates the number of passes. The presence of biliary stents did not influence the results. Abbreviations: AUC: area under the curve; EUS: endoscopic ultrasonography; EUS-FNA: fine needle aspiration under endosonographic guidance; FNA: fine needle aspiration; INR: international normalised ratio; OR: odds ratio.

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