ELASTOGRAPHY GUIDED FINE NEEDLE VERSUS STANDARD FINE NEEDLE ASPIRATION IN SOLID PANCREATIC LESIONS: A PROSPECTIVE STUDY

Aims To assess if the E-EUS-FNA is superior to standard EUS-FNA in obtaining specific diagnosis in solid pancreatic masses and the factors that can lead to different diagnostic rate.

Methods This prospective study in one tertiary medical academic center included patients with the suspicion of pancreatic solid masses on transabdominal ultrasound or CT scan. The first pass was done during elastography assessment into the blue homogenous part of the lesion and the second pass during the standard EUS assessment by using the 22G standard FNA needle EUS-FNA(Expect, Boston Scientific). The visible core was collected and analysed separately . The final diagnosis was based on EUS-FNA or surgical specimen results and on following up for 12 months by imaging methods.

Results Fifty-one patients were analysed. The mean age was 64 years old and 74% of them were male . There were 85% head and istmus pancreatic lesions, and more than 89% were stage T3 and T4. The majority of the lesions were blue homogenous on qualitative elastography assessment. The E-EUS-FNA pass and EUS-FNA had the accuracy of diagnosis of 94% and 91% respectively (p=NS) and the global accuracy of the two passes was 95%. No difference were seen for the results related to the location, size, tumor stage, chronic pancreatitis features or biliary plastic stent.

Conclusions The diagnostic rate of core obtained by using 22G FNA needles with standard EUS-FNA and guided E-EUS-FNA did not differ statistically.