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CC BY-NC-ND 4.0 · Endosc Int Open 2021; 09(06): E901-E906
DOI: 10.1055/a-1395-7129
Original article

Macroscopic on-site evaluation (MOSE) of specimens from solid lesions acquired during EUS-FNB: multicenter study and comparison between needle gauges

Benedetto Mangiavillano
 1   Gastrointestinal Endoscopy Unit – Humanitas Mater Domini – Castellanza (VA)
 2   Humamitas Huniversity
,
Leonardo Frazzoni
 3   Gastroenterology and Endoscopy Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
 4   Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
,
Thomas Togliani
 5   Digestive Endoscopy Unit, ASST Poma Hospital Mantova, Mantova, Italy
,
Carlo Fabbri
 6   Endoscopy Unit, Morgagni-Pietrantoni Hospital, Forlì-Cesena, Italy
,
Ilaria Tarantino
 7   Endoscopy Service, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS - ISMETT), Palermo, Italy
,
Luca De Luca
 8   Gastroenterology and Digestive Endoscopy Unit, Ospedali Riuniti Marche Nord, Pesaro, Italy
,
Teresa Staiano
 9   Digestive Endoscopy Unit, Candiolo Cancer Institute IRCCS, Candiolo (TO), Italy
,
Cecilia Binda
 6   Endoscopy Unit, Morgagni-Pietrantoni Hospital, Forlì-Cesena, Italy
,
Marianna Signoretti
 6   Endoscopy Unit, Morgagni-Pietrantoni Hospital, Forlì-Cesena, Italy
,
Leonardo H. Eusebi
 3   Gastroenterology and Endoscopy Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
 4   Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
,
Francesco Auriemma
 1   Gastrointestinal Endoscopy Unit – Humanitas Mater Domini – Castellanza (VA)
,
Laura Lamonaca
 1   Gastrointestinal Endoscopy Unit – Humanitas Mater Domini – Castellanza (VA)
,
Danilo Paduano
 1   Gastrointestinal Endoscopy Unit – Humanitas Mater Domini – Castellanza (VA)
,
Milena Di Leo
10   Humanitas Clinical and Research Center, Digestive Endoscopy Unit, Rozzano (Milan), Italy
,
Silvia Carrara
 2   Humamitas Huniversity
10   Humanitas Clinical and Research Center, Digestive Endoscopy Unit, Rozzano (Milan), Italy
,
Lorenzo Fuccio
 3   Gastroenterology and Endoscopy Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
 4   Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
,
Alessandro Repici
 2   Humamitas Huniversity
10   Humanitas Clinical and Research Center, Digestive Endoscopy Unit, Rozzano (Milan), Italy
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Abstract

Background and study aims The standard method for obtaining samples during endoscopic ultrasonography (EUS) is fine-needle aspiration (FNA), the accuracy of which can be affected by the presence of a cytopathologist in endoscopy room (rapid on-site evaluation [ROSE]). With the introduction of fine-needle biopsy (FNB), macroscopic on-site evaluation (MOSE) of a acquired specimen has been proposed. Only a few studies have evaluated the role of MOSE and in all except one, a 19G needle was used. Our primary aim was to evaluate the diagnostic yield and accuracy of MOSE with different needle sizes and the secondary aim was to identify factors influencing the yield of MOSE.

Patients and methods Data from patients who underwent EUS-FNB for solid lesions, with MOSE evaluation of the specimen, were collected in six endoscopic referral centers.

Results A total of 378 patients (145 F and 233 M) were enrolled. Needles sizes used during the procedures were 20G (42 %), 22G (45 %), and 25G (13 %). The median number of needle passes was two (IQR 2–3). The overall diagnostic yield of MOSE was of 90 % (confidence interval [CI] 86 %–92 %). On multivariable logistic regression analysis, variables independently associated with the diagnostic yield of MOSE were a larger needle diameter (20G vs. 25G, OR 11.64, 95 %CI 3.5–38.71; 22G vs. 25G, OR 6.20, 95 %CI 2.41–15.90) and three of more needle passes (OR 3.39, 95 %CI 1.38–8.31).

Conclusions MOSE showed high diagnostic yield and accuracy. Its yield was further increased if performed with a large size FNB needles and more than two passes.



Publication History

Received: 18 December 2020

Accepted: 04 February 2021

Article published online:
27 May 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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