Kayvan Mohkam1, Yaseen Malik1, Carlos Derosas1, John Isaac1, Ravi Marudanayagam1, Homoyoon Mehrzad2, Darius F Mirza1, Paolo Muiesan1, Keith J Roberts1, Robert P Sutcliffe3. 1. Department of Hepato-pancreato-biliary Surgery and Liver Transplantation, Queen Elizabeth Hospital, Mindelsohn Way, Edgbaston, Birmingham, B15 2WB, United Kingdom. 2. Department of Interventional Radiology, Queen Elizabeth Hospital, Mindelsohn Way, Edgbaston, Birmingham, B15 2WB, United Kingdom. 3. Department of Hepato-pancreato-biliary Surgery and Liver Transplantation, Queen Elizabeth Hospital, Mindelsohn Way, Edgbaston, Birmingham, B15 2WB, United Kingdom. Electronic address: robert.sutcliffe@uhb.nhs.uk.
Abstract
BACKGROUND: Endoscopic ultrasound fine needle aspiration (EUS-FNA) and percutaneous transhepatic cholangiographic endobiliary forceps biopsy (PTC-EFB) are valid procedures for histological assessment of proximal biliary strictures (PBS), but their performances have never been compared. This study aimed to compare the diagnostic performance of these two techniques. METHOD: The diagnostic performances of EUS-FNA and PTC-EFB were compared in a retrospective cohort of patients assessed for PBS from 2011 to 2015 at a single tertiary centre. An inverse probability of treatment weighting (IPTW) was performed to adjust for covariate imbalance. RESULTS: A total of 102 EUS-FNAs and 75 PTC-EFBs (performed in 137 patients) were compared. Patients in the PTC-EFB group had higher preoperative bilirubin (243 versus 169 μmol/l, p = 0.005) and a higher incidence of malignancy (87% versus 67%, p = 0.008). Both techniques showed specificity and positive predictive value of 100%, and similar sensitivity (69% versus 75%, p = 0.45), negative predictive value (58% versus 38%, p = 0.15) and accuracy (78% versus 79%, p = 1.00). After IPTW, the diagnostic performance of the two techniques remained similar. CONCLUSION: Compared to EUS-FNA, PTC-EFB provides similar sensitivity, negative predictive value and accuracy. It should therefore be considered as the preferred tissue-sampling procedure, if biliary drainage is indicated. Crown
BACKGROUND: Endoscopic ultrasound fine needle aspiration (EUS-FNA) and percutaneous transhepatic cholangiographic endobiliary forceps biopsy (PTC-EFB) are valid procedures for histological assessment of proximal biliary strictures (PBS), but their performances have never been compared. This study aimed to compare the diagnostic performance of these two techniques. METHOD: The diagnostic performances of EUS-FNA and PTC-EFB were compared in a retrospective cohort of patients assessed for PBS from 2011 to 2015 at a single tertiary centre. An inverse probability of treatment weighting (IPTW) was performed to adjust for covariate imbalance. RESULTS: A total of 102 EUS-FNAs and 75 PTC-EFBs (performed in 137 patients) were compared. Patients in the PTC-EFB group had higher preoperative bilirubin (243 versus 169 μmol/l, p = 0.005) and a higher incidence of malignancy (87% versus 67%, p = 0.008). Both techniques showed specificity and positive predictive value of 100%, and similar sensitivity (69% versus 75%, p = 0.45), negative predictive value (58% versus 38%, p = 0.15) and accuracy (78% versus 79%, p = 1.00). After IPTW, the diagnostic performance of the two techniques remained similar. CONCLUSION: Compared to EUS-FNA, PTC-EFB provides similar sensitivity, negative predictive value and accuracy. It should therefore be considered as the preferred tissue-sampling procedure, if biliary drainage is indicated. Crown
Authors: Anne Marie Augustin; Marcus Steingrüber; Friederika Fluck; Oliver Goetze; Thorsten Alexander Bley; Ralph Kickuth Journal: Diagn Interv Radiol Date: 2020-07 Impact factor: 2.630
Authors: Aldo Sebastián Oggero; Florencia Di Rocco; Pablo Ezequiel Huespe; Eduardo Mullen; Martín de Santibañes; Rodrigo Sanchez Claria; Oscar María Mazza; Juan Pekolk; Eduardo de Santibañes; Sung Ho Hyon Journal: Cardiovasc Intervent Radiol Date: 2021-05-04 Impact factor: 2.740