BACKGROUND: Although rapid on-site cytologic evaluation provides high efficacy of EUS-guided FNA (EUS-FNA), its availability is limited. Alternatively, macroscopic on-site quality evaluation (MOSE) may increase the efficacy of EUS-FNA. OBJECTIVE: To assess the efficacy of MOSE in estimating the adequacy of histologic core specimens obtained by EUS-FNA using a standard 19-gauge needle (19GN) for solid lesions. DESIGN: A prospective pilot study. SETTING: Tertiary-care referral center. PATIENTS: One hundred patients with solid lesions (n = 111 lesions). INTERVENTIONS: EUS-FNA using 19GN MAIN OUTCOME MEASUREMENTS: The relation of a macroscopic visible core (MVC) in the FNA specimens on MOSE with histologic core and the diagnostic yields were studied. RESULTS: The feasibility of EUS-FNA using a 19GN was 99%. The final diagnoses were malignancy in 83 lesions and benign in 28. MOSE revealed MVC in 91.1% with the median length of 8 mm. Histologic core was confirmed in 78.9%. The receiver-operating characteristic curve of the length of MVC for the presence of histologic core showed the cut-off MVC length of 4 mm with area under the curve of .893. Comparisons of per-pass diagnostic yields showed significantly superior histologic, cytologic, and overall diagnostic yields in MVC ≥ 4 mm as compared with <4 mm. The multivariate analysis for false-negative pass identified lesion in the pancreas and MVC < 4 mm as significant risk factors. No adverse events were seen. LIMITATIONS: Single center, limited operators CONCLUSION: MVC of ≥4 mm on MOSE can be an indicator of specimen adequacy and can improve diagnostic yield; however, additional FNA may be recommended for pancreatic lesions. ( CLINICAL TRIAL REGISTRATION NUMBER: UMIN000010417.).
BACKGROUND: Although rapid on-site cytologic evaluation provides high efficacy of EUS-guided FNA (EUS-FNA), its availability is limited. Alternatively, macroscopic on-site quality evaluation (MOSE) may increase the efficacy of EUS-FNA. OBJECTIVE: To assess the efficacy of MOSE in estimating the adequacy of histologic core specimens obtained by EUS-FNA using a standard 19-gauge needle (19GN) for solid lesions. DESIGN: A prospective pilot study. SETTING: Tertiary-care referral center. PATIENTS: One hundred patients with solid lesions (n = 111 lesions). INTERVENTIONS: EUS-FNA using 19GN MAIN OUTCOME MEASUREMENTS: The relation of a macroscopic visible core (MVC) in the FNA specimens on MOSE with histologic core and the diagnostic yields were studied. RESULTS: The feasibility of EUS-FNA using a 19GN was 99%. The final diagnoses were malignancy in 83 lesions and benign in 28. MOSE revealed MVC in 91.1% with the median length of 8 mm. Histologic core was confirmed in 78.9%. The receiver-operating characteristic curve of the length of MVC for the presence of histologic core showed the cut-off MVC length of 4 mm with area under the curve of .893. Comparisons of per-pass diagnostic yields showed significantly superior histologic, cytologic, and overall diagnostic yields in MVC ≥ 4 mm as compared with <4 mm. The multivariate analysis for false-negative pass identified lesion in the pancreas and MVC < 4 mm as significant risk factors. No adverse events were seen. LIMITATIONS: Single center, limited operators CONCLUSION: MVC of ≥4 mm on MOSE can be an indicator of specimen adequacy and can improve diagnostic yield; however, additional FNA may be recommended for pancreatic lesions. ( CLINICAL TRIAL REGISTRATION NUMBER: UMIN000010417.).
Authors: Elia Armellini; Erminia Manfrin; Elena Trisolini; Silvano Andorno; Marco Ballarè; Laura Bernardoni; Renzo Luciano Boldorini; Armando Gabbrielli; Luca Frulloni; Alberto Larghi; Pietro Occhipinti; Aldo Scarpa; Stefano Francesco Crinò Journal: United European Gastroenterol J Date: 2018-09-30 Impact factor: 4.623
Authors: Lawrence Mj Best; Vishal Rawji; Stephen P Pereira; Brian R Davidson; Kurinchi Selvan Gurusamy Journal: Cochrane Database Syst Rev Date: 2017-04-17
Authors: Benedetto Mangiavillano; Leonardo Frazzoni; Thomas Togliani; Carlo Fabbri; Ilaria Tarantino; Luca De Luca; Teresa Staiano; Cecilia Binda; Marianna Signoretti; Leonardo H Eusebi; Francesco Auriemma; Laura Lamonaca; Danilo Paduano; Milena Di Leo; Silvia Carrara; Lorenzo Fuccio; Alessandro Repici Journal: Endosc Int Open Date: 2021-05-27