scholarly journals The Role of EUS-Guided FNA and FNB in Autoimmune Pancreatitis

Diagnostics ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. 1653
Author(s):  
Nicolò de Pretis ◽  
Stefano Francesco Crinò ◽  
Luca Frulloni
Keyword(s):  
Pancreatic Cancer ◽  
Autoimmune Pancreatitis ◽  
Fine Needle Biopsy ◽  
Needle Aspiration ◽  
Tissue Architecture ◽  
Fine Needle ◽  
Tissue Acquisition ◽  
Histological Confirmation

Autoimmune pancreatitis (AIP) is an increasingly recognized disease classified into two different subtypes based on histology. According to the International Diagnostic Criteria (ICDC), the diagnosis is achieved using a combination of different criteria. In patients presenting with a typical imaging appearance, the diagnosis may be straightforward, and steroid treatment is recommended, even without histological confirmation. In patients with atypical imaging or mass-forming appearance, the differential diagnosis with pancreatic cancer is challenging and crucial for treatment strategy. Endoscopic ultrasound (EUS)-guided tissue acquisition has been proposed to achieve a histological diagnosis. Fine-needle aspiration (FNA) was first proposed to aspirate cells from pancreatic lesions. Despite excellent results in terms of sensitivity for pancreatic cancer, the data are disappointing regarding the diagnosis of AIP. The recent development of new needles allowing fine-needle biopsy (FNB) has been associated with improved diagnostic accuracy based on preserving the tissue architecture, which is necessary to detect the typical histological features of AIP. However, the published literature on the role of EUS-guided FNA and FNB is limited and mainly focused on type 1 AIP. The present study aimed to review the available literature on the role of EUS-guided FNA and FNB in the diagnosis of AIP.

scholarly journals Tissue acquisition and pancreatic masses: Which needle and which acquisition technique should be used?

2020 ◽  
Vol 08 (10) ◽  
pp. E1315-E1320
Author(s):  
Benedetto Mangiavillano ◽  
Leonardo Sosa-Valencia ◽  
Pierre Deprez ◽  
Pierre Eisendrath ◽  
Carlos Robles-Medranda ◽  
...  
Keyword(s):  
Treatment Options ◽  
Fine Needle Biopsy ◽  
Needle Aspiration ◽  
Histopathological Diagnosis ◽  
Fine Needle ◽  
Oncological Treatment ◽  
Pancreatic Masses ◽  
Tissue Acquisition ◽  
Acquisition Technique

Abstract Background and study aims Pancreatic cancer represents the fourth most common cause of cancer-related deaths in Western countries and the need of a low-risk investigation to obtain an accurate histopathological diagnosis has become increasingly pressing. Endoscopic ultrasonography (EUS) with fine-needle aspiration (FNA) is the standard method for obtaining samples from pancreatic masses. In recent years, there has been an increasing need to obtain histological specimens during EUS procedures, rather than cytological ones, to guide oncological treatment options, leading to the so-call “FNB concept.” Different needles have been developed for fine-needle biopsy (FNB) in recent years, enabling acquisition of larger specimens on which to perform histological and molecular analyses. The aim of this narrative review was to assess the role of EUS-guided FNA and FNB in patients with pancreatic masses, and to identify which needle and which acquisition technique should be used to improve tissue acquisition.

scholarly journals IS THE NEW PROCORE 20G DOUBLE FORWARD-BEVEL NEEDLE CAPABLE TO OBTAIN BETTER HISTOLOGICAL SAMPLES BY ENDOSCOPIC ULTRASOUND FOR DIAGNOSING SOLID PANCREATIC LESIONS?

2020 ◽  
Vol 33 (4) ◽  
Author(s):  
José Celso ARDENGH ◽  
Vitor Ottoboni BRUNALDI ◽  
Mariângela Ottoboni BRUNALDI ◽  
Alberto Facuri GASPAR ◽  
Jorge Resende LOPES-JÚNIOR ◽  
...  
Keyword(s):  
Endoscopic Ultrasound ◽  
Fine Needle Biopsy ◽  
Needle Aspiration ◽  
Technical Success ◽  
Tissue Samples ◽  
Fine Needle ◽  
Biopsy Methods ◽  
Sensitivity Specificity ◽  
Adequate Tissue

ABSTRACT Background: It is important to obtain representative histological samples of solid biliopancreatic lesions without a clear indication for resection. The role of new needles in such task is yet to be determined. Aim: To compare performance assessment between 20G double fine needle biopsy (FNB) and conventional 22G fine needle aspiration (FNA) needles for endoscopic ultrasound (EUS)-guided biopsy. Methods: This prospective study examined 20 patients who underwent the random puncture of solid pancreatic lesions with both needles and the analysis of tissue samples by a single pathologist. Results: The ProCore 20G FNB needle provided more adequate tissue samples (16 vs. 9, p=0.039) with better cellularity quantitative scores (11 vs. 5, p=0.002) and larger diameter of the histological sample (1.51±1.3 mm vs. 0.94±0.55 mm, p=0.032) than the 22G needle. The technical success, puncture difficulty, and sample bleeding were similar between groups. The sensitivity, specificity, and diagnostic accuracy were 88.9%, 100%, and 90% and 77.8%, 100%, and 78.9% for the 20G and 22G needles, respectively. Conclusions: The samples obtained with the ProCore 20G FNB showed better histological parameters; although there was no difference in the diagnostic performance between the two needles, these findings may improve pathologist performance.

scholarly journals Role of Repeated Endoscopic Ultrasound-Guided Fine Needle Aspiration for Diagnosis of Suspected Pancreatic Cancer

2021 ◽  
Vol 3 (1) ◽  
Author(s):  
F Zamani ◽  
M Haghighi ◽  
H Ajdarkosh ◽  
F Safarnezhad Tameshkel ◽  
M Hajibaba ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Endoscopic Ultrasound ◽  
Fine Needle Aspiration ◽  
Needle Aspiration ◽  
Ultrasound Guided ◽  
Fine Needle

scholarly journals Diagnostic yield of endoscopic ultrasound-guided tissue acquisition for small solid pancreatic lesions

2020 ◽  
Vol 08 (10) ◽  
pp. E1359-E1364
Author(s):  
Takafumi Mie ◽  
Takashi Sasaki ◽  
Ryo Kanata ◽  
Takaaki Furukawa ◽  
Tsuyoshi Takeda ◽  
...  
Keyword(s):  
Endoscopic Ultrasound ◽  
Diagnostic Yield ◽  
Fine Needle Biopsy ◽  
Needle Aspiration ◽  
Pancreatic Abscess ◽  
Ultrasound Guided ◽  
Predictive Values ◽  
Fine Needle ◽  
Tissue Acquisition ◽  
Sensitivity Specificity

Abstract Background and study aims Endoscopic ultrasound (EUS)-guided tissue acquisition is sometimes required to diagnose small solid pancreatic lesions. The aim of this study was to evaluate the diagnostic yield of EUS-guided tissue acquisition for small solid pancreatic lesions and the differences in diagnostic yield among different needles. Patients and method We retrospectively analyzed consecutive patients who had undergone EUS-guided tissue acquisition for solid pancreatic lesions less than 2 cm between November 2012 and June 2019. Three types of needles were evaluated in this study: a 22-gauge fine-needle aspiration (FNA) Lancet needle, a 20-gauge fine-needle biopsy (FNB) Menghini needle with a lateral forward bevel, and a 22-gauge FNB Franseen needle. We evaluated the diagnostic yield and safety of the procedure using these needles. Results We analyzed 160 patients with 163 lesions. The overall sensitivity, specificity, and accuracy were 92.0 %, 100 %, and 92.6 %, respectively. In the histological plus cytological diagnosis, accuracies of the Lancet, Menghini, and Franseen needles were 92.7 %, 97.0 %, and 85.7 %, respectively (P = 0.10). In the histological diagnosis alone, the negative predictive values (NPVs) of the Lancet, Menghini, and Franseen needles were 13.3 %, 53.3 %, and 27.3 %, respectively (P = 0.08). Adverse events occurred in four cases (2.5 %): one postprocedural bleeding, two cases of pancreatitis, and one pancreatic abscess. Conclusions EUS-guided tissue acquisition for small solid pancreatic lesions has a high diagnostic yield and safety. This study suggested a difference in the diagnostic yield of each needle for small solid pancreatic lesions.

scholarly journals Efficacy of EUS-guided FNB using a Franseen needle for tissue acquisition and microsatellite instability evaluation in unresectable pancreatic lesions

2020 ◽  
Author(s):  
Mitsuru Sugimoto ◽  
Hiroki Irie ◽  
Tadayuki Takagi ◽  
Rei Suzuki ◽  
Naoki Konno ◽  
...  
Keyword(s):  
Microsatellite Instability ◽  
Fine Needle Aspiration ◽  
Needle Biopsy ◽  
Fine Needle Biopsy ◽  
Needle Aspiration ◽  
Immune Checkpoint Blockade ◽  
Ultrasound Guided ◽  
Fine Needle ◽  
Tissue Acquisition ◽  
Histological Specimen

Abstract Background: The efficacy of immune checkpoint blockade in the treatment of microsatellite instability (MSI)-high tumors was recently reported. Therefore, the acquisition of histological specimens is desired in cases of unresectable solid pancreatic lesions (UR SPLs). This study investigated the efficacy of endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) using a Franseen needle for UR SPL tissue acquisition and MSI evaluation.Methods: A total of 195 SPL patients who underwent EUS-guided fine-needle aspiration (EUS-FNA) or EUS-FNB (EUS-FNAB) between January 2017 and March 2020 were enrolled in this study. Among them, 89 SPL patients (FNB: 28, FNA: 61) underwent EUS-FNAB using a 22-G needle (UR SPLs: 58, FNB: 22, FNA: 36) (UR SPLs after starting MSI evaluation: 23, FNB: 9, FNA: 14).Results: The puncture number was significantly lower with FNB than with FNA (median (range): 3 (2-5) vs 4 (1-8), P < 0.01, UR SPLs: 3 (2-5) vs 4 (1-8), P = 0.036). Histological specimen acquisition was more commonly achieved with FNB than with FNA (92.9% (26/28) vs 68.9% (42/61), P = 0.015, UR SPLs: 100% (22/22) vs 72.2% (26/36), P < 0.01). The histological specimen required for MSI evaluation was acquired more often with FNB than with FNA (88.9% (8/9) vs 35.7% (5/14), P = 0.03).Conclusions: EUS-FNB using a Franseen needle is efficient for histological specimen acquisition and sampling the required amount of specimen for MSI evaluation in UR SPL patients.

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