Dataset Information

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

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.

SUBMITTER: Costa-Moreira P

PROVIDER: S-EPMC7895663 | biostudies-literature | 2021 Mar

REPOSITORIES: biostudies-literature

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

Costa-Moreira Pedro P Vilas-Boas Filipe F Martins Diana D Moutinho-Ribeiro Pedro P Lopes Susana S Lopes Joanne J Barroca Helena H Macedo Guilherme G

Endoscopy international open 20210219 3

<b>Background and study aims</b> 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. <b>Patients and methods </b> Consecutive patients undergoing EUS-guided sampling of solid pancreatic lesions were recruited. A minimum o ...[more]

PMID: 33655040

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Project description:BackgroundDiagnostic laparoscopy is often a necessary, albeit invasive, procedure to help resolve undiagnosed peritoneal diseases. Previous retrospective studies reported that EUS-FNA is feasible on peritoneal and omental lesions, however, EUS-FNA provided a limited amount of tissue for immunohistochemistry stain (IHC).AimThis pilot study aims to prospectively determine the effectiveness of EUS-FNB regarding adequacy of tissue for IHC staining, diagnostic rate and the avoidance rate of diagnostic laparoscopy or percutaneous biopsy in patients with these lesions.MethodsFrom March 2017 to June 2018, patients with peritoneal or omental lesions identified by CT or MRI at the King Chulalongkorn Memorial Hospital, Bangkok, Thailand were prospectively enrolled in the study. All Patients underwent EUS-FNB. For those with negative pathological results of EUS-FNB, percutaneous biopsy or diagnostic laparoscopy was planned. Analysis uses percentages only due to small sample sizes.ResultsA total of 30 EUS-FNB passes were completed, with a median of 3 passes (range 2-3 passes) per case. For EUS-FNB, the sensitivity, specificity, PPV, NPV and accuracy of EUS-FNB from peritoneal lesions were 63.6%, 100%, 100%, 20% and 66.7% respectively. Adequate tissue for IHC stain was found in 25/30 passes (80%). The tissues from EUS results were found malignant in 7/12 patients (58.3%). IHC could be done in 10/12 patients (83.3%). Among the five patients with negative EUS results, two underwent either liver biopsy of mass or abdominal paracentesis, showing gallbladder cancer and adenocarcinoma. Two patients refused laparoscopy due to advanced pancreatic cancer and worsening ovarian cancer. The fifth patient had post-surgical inflammation only with spontaneous resolution. The avoidance rate of laparoscopic diagnosis was 58.3%. No major adverse event was observed.ConclusionsEUS-FNB from peritoneal lesions provided sufficient core tissue for diagnosis and IHC. Diagnostic laparoscopy can often be avoided in patients with peritoneal lesions.

Project description:Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is an effective technique for qualitative diagnosis of space occupying lesions in and around the wall of the digestive tract. At present, there are many studies on EUS-FNA via the upper gastrointestinal route, while there are few studies on EUS-FNA via the lower gastrointestinal route, especially for Chinese patients with pelvic mass. Therefore, this study sought to evaluate the value of transrectal EUS-FNA in the qualitative diagnosis of pelvic masses in Chinese patients. The clinical data of 35 patients with pelvic masses who underwent EUS-FNA at our hospital were collected from September 2014 to December 2021. Among these patients, 10 underwent surgical treatment after EUS-FNA, and a diagnosis was made based on a pathologic evaluation. The EUS-FNA biopsy results were compared to the final diagnostic results to calculate the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of EUS-FNA in the diagnosis of malignant pelvic mass. For the 10 patients who underwent surgery, the final diagnoses were based on the pathologic findings of surgical specimens, and for the 25 patients who did not undergo surgery, the final diagnoses were based on the malignant pathological results of EUS-FNA or clinical follow-up results. Among the 35 patients, 12 had benign lesions, including pelvic abscesses, cysts, and inflammatory masses, and 23 had malignant lesions, including mesenchymal tumors, leiomyosarcomas, teratomas, and malignant tumors with pelvic metastases. There were no complications resulting from the biopsy punctures. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of EUS-FNAs for the diagnosis of malignant pelvic masses were 91.3% (21/23), 100.0% (12/12), 100.0% (21/21), 85.7% (12/14), and 94.3% (33/35), respectively. EUS-FNA is a safe and effective method for the qualitative diagnosis of pelvic masses, and has good clinical application value.

Dataset Information

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

Publications

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

Similar Datasets

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