Download PDF
CC BY-NC-ND 4.0 · Journal of Digestive Endoscopy 2022; 13(03): 203-205
DOI: 10.1055/s-0042-1748493
News

Endoscopic Ultrasound-Guided Fine-Needle Biopsy for Pancreatic Lesions is the Way Forward: Here is the Evidence!

Daya Krishna Jha
1   Department of Gastroenterology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
,
Surinder Singh Rana
1   Department of Gastroenterology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
› Author Affiliations Funding None.
› Further Information
Also available at
   Permissions and Reprints

Abstract

Endoscopic ultrasound-guided tissue acquisition (EUS TA) has increasingly become imperative for pancreatic pathology in arriving at the correct diagnosis because of its simplicity, cost-effectiveness, and availability at high-volume centers. The advent of EUS fine-needle biopsy (FNB) has revolutionized EUS TA by providing samples that are larger and more diagnostic compared with fine-needle aspiration (FNA). Rapid onsite evaluation (ROSE) has been conventionally used for improving the cytological yield as well as diagnostic accuracy of EUS FNA. The development of FNB has obviated the need for ROSE, and evidence from retrospective and comparative studies has suggested that FNB is as good as FNA with ROSE in terms of diagnostic accuracy and reduced costs. However, strong evidence in the form of a randomized controlled trial (RCT) was missing. In this news and views, we discuss a multicenter RCT that has compared the diagnostic accuracy of EUS FNB alone to EUS FNA with ROSE in patients with solid pancreatic lesions. This study has reemphasized that EUS FNB has a diagnostic accuracy comparable to EUS + ROSE at a comparable cost and requires fewer passes and has a shorter procedure time.

Keywords

endosonography - fine-needle biopsy - fine-needle aspiration

Author Contributions

D.K.J. contributed to collection and interpretation of data and drafting of manuscript. S.S.R. contributed to collection and interpretation of data, drafting, as well as critical evaluation of manuscript for intellectual content.




Publication History

Article published online:
13 September 2022

© 2022. Society of Gastrointestinal Endoscopy of India. 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/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Rana A, Rana SS. Endoscopic ultrasound-guided tissue acquisition: techniques and challenges. J Cytol 2019; 36 (01) 1-7
    CrossrefPubMedGoogle Scholar
  • 2 Kovacevic B, Vilmann P. EUS tissue acquisition: from A to B. Endosc Ultrasound 2020; 9 (04) 225-231
    Google Scholar
  • 3 Varadarajulu S, Tamhane A, Eloubeidi MA. Yield of EUS-guided FNA of pancreatic masses in the presence or the absence of chronic pancreatitis. Gastrointest Endosc 2005; 62 (05) 728-736 , quiz 751, 753
    CrossrefPubMedGoogle Scholar
  • 4 Klapman JB, Logrono R, Dye CE, Waxman I. Clinical impact of on-site cytopathology interpretation on endoscopic ultrasound-guided fine needle aspiration. Am J Gastroenterol 2003; 98 (06) 1289-1294
    CrossrefPubMedGoogle Scholar
  • 5 James TW, Baron TH. A comprehensive review of endoscopic ultrasound core biopsy needles. Expert Rev Med Devices 2018; 15 (02) 127-135
    CrossrefPubMedGoogle Scholar
  • 6 Ashat M, Klair JS, Rooney SL. et al. Randomized controlled trial comparing the Franseen needle with the fork-tip needle for EUS-guided fine-needle biopsy. Gastrointest Endosc 2021; 93 (01) 140-150.e2
    CrossrefPubMedGoogle Scholar
  • 7 Bang JY, Hebert-Magee S, Navaneethan U, Hasan MK, Hawes R, Varadarajulu S. Randomized trial comparing the Franseen and fork-tip needles for EUS-guided fine-needle biopsy sampling of solid pancreatic mass lesions. Gastrointest Endosc 2018; 87 (06) 1432-1438
    CrossrefPubMedGoogle Scholar
  • 8 Khan MA, Grimm IS, Ali B. et al. A meta-analysis of endoscopic ultrasound-fine-needle aspiration compared to endoscopic ultrasound-fine-needle biopsy: diagnostic yield and the value of onsite cytopathological assessment. Endosc Int Open 2017; 5 (05) E363-E375
    Article in Thieme ConnectPubMedGoogle Scholar
  • 9 de Moura DTH, McCarty TR, Jirapinyo P. et al. Evaluation of endoscopic ultrasound fine-needle aspiration versus fine-needle biopsy and impact of rapid on-site evaluation for pancreatic masses. Endosc Int Open 2020; 8 (06) E738-E747
    Article in Thieme ConnectPubMedGoogle Scholar
  • 10 Chen YI, Chatterjee A, Berger R. et al. Endoscopic ultrasound (EUS)-guided fine needle biopsy alone vs. EUS-guided fine needle aspiration with rapid onsite evaluation in pancreatic lesions: a multicenter randomized trial. Endoscopy 2022; 54 (01) 4-12
    Article in Thieme ConnectPubMedGoogle Scholar
  • 11 Crinò SF, Di Mitri R, Nguyen NQ. et al. Endoscopic ultrasound-guided fine-needle biopsy with or without rapid on-site evaluation for diagnosis of solid pancreatic lesions: a randomized controlled non-inferiority trial. Gastroenterology 2021; 161 (03) 899-909.e5
    Google Scholar