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Endosc Int Open 2015; 03(04): E329-E333
DOI: 10.1055/s-0034-1391964
Original article
© Georg Thieme Verlag KG Stuttgart · New York

A prospective randomized study of the difference in diagnostic yield between endoscopic ultrasound-guided fine-needle aspiration (EUSFNA) needles with and without a side port in pancreatic masses

Tiing Leong Ang
1   Department of Gastroenterology and Hepatology, Changi General Hospital, Singapore
,
Andrew Boon Eu Kwek
1   Department of Gastroenterology and Hepatology, Changi General Hospital, Singapore
,
Dong Wan Seo
2   Division of Gastroenterology, Asan Medical Centre, Seoul, Korea
,
Woo Hyun Paik
2   Division of Gastroenterology, Asan Medical Centre, Seoul, Korea
,
Tsu-Yao Cheng
3   Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
,
Hsiu-Po Wang
3   Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
,
James Lau
4   Department of Surgery, Chinese University of Hong Kong, Hong Kong, China
› Author Affiliations
Further Information

Publication History

submitted 10 December 2014

accepted after revision 04 March 2015

Publication Date:
26 May 2015 (online)

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Background and study aims: Two 22G needles with similar designs, apart from the absence (A) or presence of a side port (B), are available for endoscopic ultrasound (EUS)-guided fine-needle aspiration (FNA). The side port was designed to increase diagnostic yield but this advantage was unproven. This study evaluated the difference in diagnostic yield between both needles in pancreatic masses.

Patients and methods: This was a prospective multicenter randomized cross-over study. Patients with pancreatic masses were randomized to one needle for the first two passes, followed by the other for the next two passes. A pathologist blinded to the needle assessed each puncture for cellularity and morphology. The diagnostic yield between both needles was compared.

Results: In total, 30 patients were recruited (mean lesion size: 3.5 cm, range: 1.2 – 6.3). Comparison of cellularity adequacy: first pass: A vs. B: 26/30 vs. 24/30 (P = 0.488): 2nd pass: A vs. B: 25/30 vs. 26/30 (P = 0.718). Comparison of diagnostic accuracy: first pass: A vs. B: 22/30 vs. 23/30 (P = 0.766); after two passes: A vs. B: 26/30 vs. 26/30 (P = 1.0). When all four passes were assessed, adequate cellularity was obtained in 29/30 and the correct diagnosis was obtained in 28/30 patients. There were no procedural complications.

Conclusions: There was no significant difference in diagnostic yield between EUSFNA needles with or without a side port for pancreatic masses.

Study registration: NCT02092519.

 

  • References

  • 1 Gan SI, Rajan E, Adler DG et al. The role of EUS. Gastrointest Endosc 2007; 66: 425-434
    CrossrefPubMedGoogle Scholar
  • 2 Wani S, Wallace MB, Cohen J et al. Quality indicators for EUS. Gastrointest Endosc 2015; 81: 67-80
    CrossrefPubMedGoogle Scholar
  • 3 Polkowski M, Larghi A, Weynand B et al. Learning, techniques, and complications of endoscopic ultrasound (EUS)-guided sampling in gastroenterology: European Society of Gastrointestinal Endoscopy (ESGE) Technical Guideline. Endoscopy 2012; 44: 190-205
    Article in Thieme ConnectPubMedGoogle Scholar
  • 4 Pellisé Urquiza M, Fernández-Esparrach G, Solé M et al. Endoscopic ultrasound-guided fine needle aspiration: predictive factors of accurate diagnosis and cost-minimization analysis of on-site pathologist. Gastroenterol Hepatol 2007; 30: 319-324
    CrossrefPubMedGoogle Scholar
  • 5 Holt BA, Varadarajulu S, Hebert-Magee S. High-quality endoscopic ultrasound-guided fine needle aspiration tissue acquisition. Adv Ther 2014; 31: 696-707
    CrossrefPubMedGoogle Scholar
  • 6 Iglesias-Garcia J, Poley JW, Larghi A et al. Feasibility and yield of a new EUS histology needle: results from a multicenter, pooled, cohort study. Gastrointest Endosc 2011; 73: 1189-1196
    CrossrefPubMedGoogle Scholar
  • 7 Hucl T, Wee E, Lakhtakia S et al. Feasibility and efficiency of a new 22G core needle: a prospective comparison study. Endoscopy 2013; 45: 792-798
    Article in Thieme ConnectPubMedGoogle Scholar
  • 8 Kaffes A, Corte C. Fine needle aspiration at endoscopic ultrasound with a novel side-port needle: a pilot experience. Therap Adv Gastroenterol 2012; 5: 89-94
    CrossrefPubMedGoogle Scholar
  • 9 Kaffes AJ, Chen RY, Tam W et al. A prospective multicenter evaluation of a new side-port endoscopic ultrasound-fine-needle aspiration in solid upper gastrointestinal lesions. Dig Endosc 2012; 24: 448-451
    CrossrefPubMedGoogle Scholar
  • 10 Boustière C, Veitch A, Vanbiervliet G et al. Endoscopy and antiplatelet agents. European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy 2011; 43: 445-461
    Article in Thieme ConnectPubMedGoogle Scholar
  • 11 Vilmann P, Saftoiu A. Endoscopic ultrasound-guided fine needle aspiration biopsy: equipment and technique. J Gastroenterol Hepatol 2006; 21: 1646-1655
    CrossrefPubMedGoogle Scholar
  • 12 Moller K, Papanikolaou IS, Toermer T et al. EUS-guided FNA of solid pancreatic masses: high yield of 2 passes with combined histologic-cytologic analysis. Gastrointest Endosc 2009; 70: 60-69
    CrossrefPubMedGoogle Scholar
  • 13 Turner BG, Cizginer S, Agarwal D et al. Diagnosis of pancreatic neoplasia with EUS and FNA: a report of accuracy. Gastrointest Endosc 2010; 71: 91-98
    CrossrefPubMedGoogle Scholar
  • 14 Wallace MB, Kennedy T, Durkalski V et al. Randomized controlled trial of EUS-guided fine needle aspiration techniques for the detection of malignant lymphadenopathy. Gastrointest Endosc 2001; 54: 441-447
    CrossrefPubMedGoogle Scholar
  • 15 Puri R, Vilmann P, Săftoiu A et al. Randomized controlled trial of endoscopic ultrasound-guided fine-needle sampling with or without suction for better cytological diagnosis. Scand J Gastroenterol 2009; 44: 499-504
    CrossrefPubMedGoogle Scholar