Endoscopic ultrasound with combined fine needle aspiration plus biopsy improves diagnostic yield in solid pancreatic masses. (4th May 2022)

• Record Type: Journal Article
• Authors: Gonzalez, Adalberto; Wadhwa, Vaibhav; Singh, Harjinder; Khan, Sikandar; Gupta, Kapil; Liang, Hong; Hussain, Ishtiaq; Vargo, John; Jang, Sunguk; Chahal, Prabhleen; Bhatt, Amit; Siddiki, Hassan; Erim, Tolga; Sanaka, Madhusudhan R.
• Is Part Of: Scandinavian journal of gastroenterology. Volume 57:Number 5(2022)
• Page Start: 610
• Page End: 617
• Publication Date: 2022-05-04
• Subjects: Endoscopic ultrasound -- fine needle aspiration -- fine needle biopsy -- pancreatic cancer -- diagnostic yield; Gastroenterology -- Periodicals; Digestive organs -- Diseases -- Periodicals; 616.33
• DOI: 10.1080/00365521.2021.2024249
• Languages: English
• ISSNs: 0036-5521

Abstract

Abstract: Goals: Our aim was to compare the diagnostic yield of endoscopic ultrasound guided fine needle aspiration (EUS-FNA) versus combined fine needle aspiration and fine needle biopsy (EUS-FNA + FNB) in the evaluation of solid pancreatic masses (SPMs). Background: EUS-FNA and EUS-FNB are established methods to diagnose SPMs. No studies have evaluated the efficacy of combination of both (EUS-FNA + FNB). Our senior author (MRS) hypothesized that combining the two techniques by using a single FNB needle improves diagnostic yield and started combination technique in October 2016. Study: Patients who underwent EUS for SPMs by MRS during January 2014–September 2019 were included. They were divided into the EUS-FNA group and EUS-FNA + FNB group. EUS-FNA was performed using a 22 or 25 gauge Expect Slimline needle (Boston Scientific, Marlborough, MA) and EUS-FNA + FNB was performed using a single 22 or 25 gauge Shark-core needle (Medtronics, Minneapolis, MN, USA). Our primary outcome was to compare the diagnostic yield in the two groups. Results: Among 105 patients included, 58 were in the EUS-FNA group and 47 were in the EUS-FNA + FNB group. EUS-FNA + FNB group had significantly higher diagnostic yield and required fewer needle passes compared to EUS-FNA group, 95.7% vs. 77.6%, p = .01: and 4 vs. 5, p = .002; respectively. Procedural duration was similar in both groups but the combined technique required less number of needles per procedure. There was no difference in adverse events in the two groups. Conclusion: Our study showed that combined EUS-FNA + FNB had higher diagnostic yield compared to EUS-FNA in SPMs along with less number of needle passes and needles required. Further prospective studies are needed to validate these findings and cost-effectiveness of this strategy.