Antonio Facciorusso1, Sachin Wani2, Konstantinos Triantafyllou3, Georgios Tziatzios3, Renato Cannizzaro4, Nicola Muscatiello1, Siddharth Singh5. 1. Endoscopy Unit, University of Foggia, Foggia, Italy. 2. University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA. 3. Hepatogastroenterology Unit, National and Kapodistrian University of Athens, Athens, Greece. 4. Oncological Gastroenterology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy. 5. Division of Gastroenterology, University of California San Diego, San Diego, California, USA.
Abstract
BACKGROUND AND AIMS: Variable diagnostic performance of sampling techniques during EUS-guided tissue acquisition of solid pancreatic masses based on needle type (FNA versus fine-needle biopsy [FNB]) and gauge (19-gauge vs 22-gauge vs 25-gauge) has been reported. We performed a systematic review with network meta-analysis to compare the diagnostic accuracy of EUS-guided techniques for sampling solid pancreatic masses. METHODS: Through a systematic literature review to November 2018, we identified 27 randomized controlled trials (2711 patients) involving adults undergoing EUS-guided sampling of solid pancreatic masses that evaluated the diagnostic performance of FNA and FNB needles based on needle gauge. The primary outcome was diagnostic accuracy. Secondary outcomes were sample adequacy, histologic core procurement rate, and number of needle passes. We performed pairwise and network meta-analyses and appraised the quality of evidence using GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology. RESULTS: In the network meta-analysis, no specific EUS-guided tissue sampling technique was superior, based on needle type (FNA vs FNB) or gauge (19-gauge vs 22-gauge vs 25-gauge) (low-quality evidence). Specifically, there was no difference between 25-gauge FNA versus 22-gauge FNA (relative risk [RR], 1.03; 95% confidence interval [CI], 0.91-1.17) and 22-gauge FNB versus 22-gauge FNA (RR, 1.03; 95% CI, 0.89-1.18) needles for diagnostic accuracy, sample adequacy, and histologic core procurement. Findings were confirmed in sensitivity analysis restricted to studies with no rapid on-site cytologic evaluation and no use of the fanning technique. CONCLUSION: In a network meta-analysis, no specific EUS-guided tissue sampling technique was superior with regard to diagnostic accuracy, sample adequacy, or histologic procurement rate for solid pancreatic masses, with low confidence in estimates.
BACKGROUND AND AIMS: Variable diagnostic performance of sampling techniques during EUS-guided tissue acquisition of solid pancreatic masses based on needle type (FNA versus fine-needle biopsy [FNB]) and gauge (19-gauge vs 22-gauge vs 25-gauge) has been reported. We performed a systematic review with network meta-analysis to compare the diagnostic accuracy of EUS-guided techniques for sampling solid pancreatic masses. METHODS: Through a systematic literature review to November 2018, we identified 27 randomized controlled trials (2711 patients) involving adults undergoing EUS-guided sampling of solid pancreatic masses that evaluated the diagnostic performance of FNA and FNB needles based on needle gauge. The primary outcome was diagnostic accuracy. Secondary outcomes were sample adequacy, histologic core procurement rate, and number of needle passes. We performed pairwise and network meta-analyses and appraised the quality of evidence using GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology. RESULTS: In the network meta-analysis, no specific EUS-guided tissue sampling technique was superior, based on needle type (FNA vs FNB) or gauge (19-gauge vs 22-gauge vs 25-gauge) (low-quality evidence). Specifically, there was no difference between 25-gauge FNA versus 22-gauge FNA (relative risk [RR], 1.03; 95% confidence interval [CI], 0.91-1.17) and 22-gauge FNB versus 22-gauge FNA (RR, 1.03; 95% CI, 0.89-1.18) needles for diagnostic accuracy, sample adequacy, and histologic core procurement. Findings were confirmed in sensitivity analysis restricted to studies with no rapid on-site cytologic evaluation and no use of the fanning technique. CONCLUSION: In a network meta-analysis, no specific EUS-guided tissue sampling technique was superior with regard to diagnostic accuracy, sample adequacy, or histologic procurement rate for solid pancreatic masses, with low confidence in estimates.
Authors: Songming Ding; Aili Lu; Xinhua Chen; Bingqian Xu; Ning Wu; Muhammad Ibrahim Alhadi Edoo; Shusen Zheng; Qiyong Li Journal: Int J Med Sci Date: 2020-10-16 Impact factor: 3.738
Authors: Jintao Guo; Anand V Sahai; Anthony Teoh; Paolo Giorgio Arcidiacono; Alberto Larghi; Adrian Saftoiu; Ali A Siddiqui; Brenda Lucia Arturo Arias; Christian Jenssen; Douglas G Adler; Sundeep Lakhtakia; Dong-Wan Seo; Fumihide Itokawa; Marc Giovannini; Girish Mishra; Luis Sabbagh; Atsushi Irisawa; Julio Iglesias-Garcia; Jan Werner Poley; Juan J Vila; Lachter Jesse; Kensuke Kubota; Evangelos Kalaitzakis; Mitsuhiro Kida; Mohamed El-Nady; Sh Untaro Mukai; Takeshi Ogura; Pietro Fusaroli; Peter Vilmann; Praveer Rai; Nam Q Nguyen; Ryan Ponnudurai; Chalapathi Rao Achanta; Todd H Baron; Ichiro Yasuda; Hsiu-Po Wang; Jinlong Hu; Bowen Duan; Manoop S Bhutani; Siyu Sun Journal: Endosc Ultrasound Date: 2020 Sep-Oct Impact factor: 5.628
Authors: Moon Jae Chung; Se Woo Park; Seong-Hun Kim; Chang Min Cho; Jun-Ho Choi; Eun Kwang Choi; Tae Hoon Lee; Eunae Cho; Jun Kyu Lee; Tae Jun Song; Jae Min Lee; Jun Hyuk Son; Jin Suk Park; Chi Hyuk Oh; Dong-Ah Park; Jeong-Sik Byeon; Soo Teik Lee; Ho Gak Kim; Hoon Jai Chun; Ho Soon Choi; Chan Guk Park; Joo Young Cho Journal: Clin Endosc Date: 2021-03-24
Authors: Moon Jae Chung; Se Woo Park; Seong-Hun Kim; Chang Min Cho; Jun-Ho Choi; Eun Kwang Choi; Tae Hoon Lee; Eunae Cho; Jun Kyu Lee; Tae Jun Song; Jae Min Lee; Jun Hyuk Son; Jin Suk Park; Chi Hyuk Oh; Dong-Ah Park; Jeong-Sik Byeon; Soo Teik Lee; Ho Gak Kim; Hoon Jai Chun; Ho Soon Choi; Chan Guk Park; Joo Young Cho Journal: Gut Liver Date: 2021-05-15 Impact factor: 4.519
Authors: Samuel Han; Furqan Bhullar; Omar Alaber; Ayesha Kamal; Puanani Hopson; Kavin Kanthasamy; Sarah Coughlin; Livia Archibugi; Nikhil Thiruvengadam; Christopher Moreau; David Jin; Pedram Paragomi; Francisco Valverde-López; Sajan Nagpal; Cemal Yazici; Georgios Papchristou; Peter J Lee; Venkata Akshintala Journal: Endosc Int Open Date: 2021-05-27