Monitored needle acceleration in endoscopic ultrasound-guided fine-needle aspiration of solid pancreatic masses improves sample quality and diagnostic accuracy: a randomized trial

Abstract

Background Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is recommended for the diagnosis of solid pancreatic masses. We aimed to evaluate whether a high needle movement acceleration value during puncture increases diagnostic accuracy.

Methods EUS-FNA needle acceleration was measured using a PocketLab accelerometer connected by Bluetooth to a smartphone. Two passes (fast and slow, with higher and lower than 1g [9.8 m/s²] needle acceleration values, respectively) were performed in a random order. The sample cellularity and quality were measured using semiquantitative scales.

Results 51 patients were included (32 women; mean age 63). The mean (standard deviation [SD]) acceleration values were 1.59g (0.66g) for the fast pass and 0.32g (0.19g) for the slow pass (P < 0.001). The fast pass yielded significantly higher levels of EUS-FNA accuracy (84.3 % vs. 68.6 %; P = 0.02) and adequate quality scores (94.1 % vs. 76.5 %; P = 0.007). High cellularity scores were seen with similar frequencies (15.7 % vs. 11.8 %; P = 0.32).

Conclusions A higher than 1g EUS-FNA needle acceleration may increase the diagnostic accuracy and specimen quality from solid pancreatic lesions.

Publikationsverlauf

Eingereicht: 11. Oktober 2020

Angenommen nach Revision: 03. Mai 2021

Accepted Manuscript online:
03. Mai 2021

Artikel online veröffentlicht:
01. Juli 2021

• References

• 1 Dumonceau JM, Deprez PH, Jenssen C. et al. Indications, results, and clinical impact of endoscopic ultrasound (EUS)-guided sampling in gastroenterology: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline –Updated January 2017. Endoscopy 2017; 49: 695-714
• 2 Mukai S, Itoi T, Ashida R. et al. Multicenter, prospective, crossover trial comparing the door-knocking method with the conventional method for EUS-FNA of solid pancreatic masses (with videos). Gastrointest Endosc 2016; 83: 1210-1217
• 3 Bang JY, Magee SH, Ramesh J. et al. Randomized trial comparing fanning with standard technique for endoscopic ultrasound-guided fine-needle aspiration of solid pancreatic mass lesions. Endoscopy 2013; 45: 445-450
• 4 Khan S, Omar T, Michelow P. Effectiveness of the cell block technique in diagnostic cytopathology. J Cytol 2012; 29: 177-182
• 5 Pitman MB, Centeno BA, Ali SZ. et al. Standardized terminology and nomenclature for pancreatobiliary cytology: the Papanicolaou Society of Cytopathology guidelines. Diagn Cytopathol 2014; 42: 338-350
• 6 Sakamoto H, Kitano M, Komaki T. et al. Prospective comparative study of the EUS guided 25-gauge FNA needle with the 19-gauge Trucut needle and 22-gauge FNA needle in patients with solid pancreatic masses. J Gastroenterol Hepatol 2009; 24: 384-390
• 7 Mahvash M, Dupont PE. Mechanics of dynamic needle insertion into a biological material. IEEE Trans Biomed Eng 2010; 57: 934-943
• 8 Ghassemi NH, Marxreiter F, Pasluosta CF. et al. Combined accelerometer and EMG analysis to differentiate essential tremor from Parkinson's disease. Annu Int Conf IEEE Eng Med Biol Soc 2016; 2016: 672-675
• 9 Kimm D, Thiel DV. Hand speed measurements in boxing. Procedia Engineering 2015; 112: 502-506
• 10 van Riet PA, Quispel R, Cahen DL. et al. Diagnostic yield and agreement on fine-needle specimens from solid pancreatic lesions: comparing the smear technique to liquid-based cytology. Endosc Int Open 2020; 8: E155-E162
• 11 Hamid M, Tbouda M, Majbar AM. et al. Pancreatic solid serous cystadenoma treated by laparoscopy: Presentation of a new case report and review of the literature. Int J Surg Case Rep 2017; 40: 97-101
• 12 Polkowski M, Jenssen C, Kaye P. et al. Technical aspects of endoscopic ultrasound (EUS)-guided sampling in gastroenterology: European Society of Gastrointestinal Endoscopy (ESGE) Technical Guideline – March 2017. Endoscopy 2017; 49: 989-1006