Clinical Endoscopy

Original Articles

Endoscopic Ultrasound-Guided Fine Needle Biopsy Needles Provide Higher Diagnostic Yield Compared to Endoscopic Ultrasound-Guided Fine Needle Aspiration Needles When Sampling Solid Pancreatic Lesions: A Meta-Analysis: Benjamin D. Renelus, Daniel S. Jamorabo, Iman Boston, William M. Briggs, John M. Poneros; Clin Endosc 2021;54(2):261-268. Published online August 31, 2020; DOI: https://doi.org/10.5946/ce.2020.101

Background
/Aims: Studies comparing the utility of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) and endoscopic ultrasound-guided fine needle biopsy (EUS-FNB) for solid pancreatic lesions have been inconclusive with no clear superiority. The aim of this meta-analysis was to compare the diagnostic accuracy and safety between the two sampling techniques.
Methods
We performed a systematic search of randomized controlled trials published between 2012 and 2019. The primary outcome was overall diagnostic accuracy. Secondary outcomes included adverse event rates, cytopathologic and histopathologic accuracy, and the mean number of passes required to obtain adequate tissue between FNA and FNB needles. Fixed and random effect models with pooled estimates of target outcomes were developed.
Results
Eleven studies involving 1,365 participants were included for analysis. When compared to FNB, FNA had a significant reduction in diagnostic accuracy (81% and 87%, p=0.005). In addition, FNA provided reduced cytopathologic accuracy (82% and 89%, p=0.04) and an increased number of mean passes required compared to FNB (2.3 and 1.6, respectively, p<0.0001). There was no difference in adverse event rate between FNA and FNB needles (1.8% and 2.3% respectively, p=0.64).
Conclusions
FNB provides superior diagnostic accuracy without compromising safety when compared to FNA. FNB should be readily considered by endosonographers when evaluating solid pancreatic masses.

Citations

Citations to this article as recorded by

The yield of cytology and histology obtained by endoscopic ultrasound‐guided fine needle aspiration and biopsy needles in the diagnosis of pancreatic adenocarcinoma
Wisam Sbeit, Nidaa Abu Hanna, Livoff Alejandro, Tawfik Khoury
Cytopathology.2024; 35(1): 92. CrossRef
Diagnosis of lung squamous cell carcinoma using EUS-guided fine-needle biopsy sampling of a lung lesion
Jenson Phung, Mohamed Abdallah, Mohammad Bilal
iGIE.2024; 3(1): 32. CrossRef
EUS-guided tissue acquisition in patients with solid pseudopapillary neoplasms of the pancreas
José M. Jiménez-Gutiérrez, José G. de la Mora-Levy, Juan O. Alonso-Lárraga, Angélica I. Hernández-Guerrero, Betsabé A. Soriano-Herrera, Lidia F. Villegas-González, Luis F. Uscanga-Domínguez, Stephanie López-Romero, Félix I. Téllez-Ávila
Postgraduate Medicine.2024; 136(1): 78. CrossRef
Endoscopic Ultrasound-Guided Fine-Needle Biopsy Versus Aspiration for Tissue Sampling Adequacy for Molecular Testing in Pancreatic Ductal Adenocarcinoma
Wael T. Mohamed, Vinay Jahagirdar, Fouad Jaber, Mohamed K. Ahmed, Ifrah Fatima, Thomas Bierman, Zhuxuan Fu, Philip G. Jones, Amira F. Hassan, Erin Faber, Wendell K. Clarkston, Hassan Ghoz, Ossama W. Tawfik, Sreeni Jonnalagadda
Cancers.2024; 16(4): 761. CrossRef
Endoscopic ultrasound‐guided biopsy using a three‐prong asymmetry tip needle for pancreatic tumors and peridigestive tract lesions: Retrospective single‐center study
Kento Shionoya, Ryosuke Tonozuka, Shuntaro Mukai, Takayoshi Tsuchiya, Reina Tanaka, Kenjiro Yamamoto, Kazumasa Nagai, Yukitoshi Mastunami, Hiroyuki Kojima, Takao Itoi
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Liqi Sun, Yuqiong Li, Qiuyue Song, Lisi Peng, Ying Xing, Haojie Huang, Zhendong Jin
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Experience of Endoscopic Ultrasound Guided Fine Needle Aspiration and Fine Needle Biopsy: Data from Tertiary Care Hospital in Pakistan
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Diagnostic value of endoscopic ultrasound in groove pancreatitis
Yu Mo She, Nan Ge
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Ali Zakaria, Bayan Al-Share, Jason B. Klapman, Aamir Dam
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Woo Hyun Paik
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Galab M. Hassan, Louise Laporte, Sarto C. Paquin, Charles Menard, Anand V. Sahai, Benoît Mâsse, Helen Trottier
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Lawrence Ku, Linda A. Hou, Viktor E. Eysselein, Sofiya Reicher
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Endoscopic ultrasound‐guided fine‐needle biopsy histology with a 22‐gauge Franseen needle and fine‐needle aspiration liquid‐based cytology with a conventional 25‐gauge needle provide comparable diagnostic accuracy in solid pancreatic lesions
Yoichi Tomita, Yuichi Torisu, Masafumi Chiba, Yuji Kinoshita, Takafumi Akasu, Nana Shimamoto, Takahiro Abe, Keisuke Kanazawa, Kazuki Takakura, Shintaro Tsukinaga, Masanori Nakano, Hirobumi Toyoizumi, Masayuki Kato, Masayuki Saruta
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Clinical Endoscopy.2021; 54(5): 730. CrossRef

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The Role of Endoscopic Ultrasound-Guided Ki67 in the Management of Non-Functioning Pancreatic Neuroendocrine Tumors: YongYan Cui, Lauren G. Khanna, Anjali Saqi, John P. Crapanzano, James M. Mitchell, Amrita Sethi, Tamas A. Gonda, Michael D. Kluger, Beth A. Schrope, John Allendorf, John A. Chabot, John M. Poneros; Clin Endosc 2020;53(2):213-220. Published online July 15, 2019; DOI: https://doi.org/10.5946/ce.2019.068

Abstract PDF PubReader ePub

Background
/Aims: The management of small, incidentally discovered nonfunctioning pancreatic neuroendocrine tumors (NF-PNETs) has been a matter of debate. Endoscopic ultrasound with fine-needle aspiration (EUS-FNA) is a tool used to identify and risk-stratify PNETs. This study investigates the concordance rate of Ki67 grading between EUS-FNA and surgical pathology specimens in NFPNETs and whether certain NF-PNET characteristics are associated with disease recurrence and disease-related death.
Methods
We retrospectively reviewed the clinical history, imaging, endoscopic findings, and pathology records of 37 cases of NFPNETs that underwent pre-operative EUS-FNA and surgical resection at a single academic medical center.
Results
There was 73% concordance between Ki67 obtained from EUS-FNA cytology and surgical pathology specimens; concordance was the highest for low- and high-grade NF-PNETs. High-grade Ki67 NF-PNETs based on cytology (p=0.028) and histology (p=0.028) were associated with disease recurrence and disease-related death. Additionally, tumors with high-grade mitotic rate (p=0.005), tumor size >22.5 mm (p=0.104), and lymphovascular invasion (p=0.103) were more likely to have poor prognosis.
Conclusions
NF-PNETs with high-grade Ki67 on EUS-FNA have poor prognosis despite surgical resection. NF-PNETs with intermediate-grade Ki67 on EUS-FNA should be strongly considered for surgical resection. NF-PNETs with low-grade Ki67 on EUSFNA can be monitored without surgical intervention, up to tumor size 20 mm.

Citations

Citations to this article as recorded by

Accurate non-invasive grading of nonfunctional pancreatic neuroendocrine tumors with a CT derived radiomics signature
Ammar A. Javed, Zhuotun Zhu, Benedict Kinny-Köster, Joseph R. Habib, Satomi Kawamoto, Ralph H. Hruban, Elliot K. Fishman, Christopher L. Wolfgang, Jin He, Linda C. Chu
Diagnostic and Interventional Imaging.2024; 105(1): 33. CrossRef
Preoperative Prediction of Lymph Node Metastases in Nonfunctional Pancreatic Neuroendocrine Tumors Using a Combined CT Radiomics–Clinical Model
Taha M. Ahmed, Zhuotun Zhu, Mohammad Yasrab, Alejandra Blanco, Satomi Kawamoto, Jin He, Elliot K. Fishman, Linda Chu, Ammar A. Javed
Annals of Surgical Oncology.2024;[Epub] CrossRef
Endoscopic Ultrasound-Guided Fine Needle Acquisition for Evaluation of Pancreatic Neuroendocrine Tumors
Xiaohua Ye, Hongjun Hua, Chunxiao Hu, Jianying Dai, Chenjiao Wu, Jiaping Huai, Zhe Shen
Journal of Clinical Gastroenterology.2024;[Epub] CrossRef
Improving fine needle aspiration to predict the tumor biological aggressiveness in pancreatic neuroendocrine tumors using Ki-67 proliferation index, phosphorylated histone H3 (PHH3), and BCL-2
Chaohui Lisa Zhao, Bahram Dabiri, Iman Hanna, Lili Lee, Zhang Xiaofei, Zarrin Hossein-Zadeh, Wenqing Cao, John Allendorf, Alex Pipas Rodriguez, Katherine Weng, Solomon Turunbedu, Adrienne Boyd, Mala Gupta
Annals of Diagnostic Pathology.2023; 65: 152149. CrossRef
Grading Pancreatic Neuroendocrine Tumors Via Endoscopic Ultrasound-guided Fine Needle Aspiration
Ammar A. Javed, Alessandra Pulvirenti, Samrah Razi, Jian Zheng, Theodoros Michelakos, Yurie Sekigami, Elizabeth Thompson, David S. Klimstra, Vikram Deshpande, Aatur D. Singhi, Matthew J. Weiss, Christopher L. Wolfgang, John L. Cameron, Alice C. Wei, Amer
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Assessment of ARX expression, a novel biomarker for metastatic risk in pancreatic neuroendocrine tumors, in endoscopic ultrasound fine‐needle aspiration
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The Utility of Endoscopic Ultrasound in Patients with Isolated Elevations in Serum Amylase and/or Lipase: Lalitha M. Sitaraman, Amit H. Sachdev, Tamas A. Gonda, Amrita Sethi, John M. Poneros, Frank G. Gress; Clin Endosc 2019;52(2):175-181. Published online January 16, 2019; DOI: https://doi.org/10.5946/ce.2018.110

Abstract PDF PubReader ePub

Background
/Aims: The aim of this study was to describe the diagnostic yield of endoscopic ultrasound (EUS) in patients with isolated elevated levels of amylase and/or lipase.
Methods
A retrospective chart review was conducted at a large academic medical center from 2000 to 2016. Patients were selected based on having elevated amylase, lipase, or both, but without a diagnosis of pancreatitis or known pancreatobiliary disease. Patients were excluded if they had abnormal liver function tests or abnormal imaging of the pancreas.
Results
Of 299 EUS procedures performed, 38 met inclusion criteria. Symptoms were present in 31 patients, most frequently abdominal pain (87%). In 20 patients (53%), initial EUS most commonly found chronic pancreatitis (n=7; 18%), sludge (5; 13%), or new diagnosis of pancreas divisum (3; 8%). In the asymptomatic patients (7), 3 had a finding on EUS, most importantly sludge (2), stone (1), and pancreas divisum (1). No patients were diagnosed with a mass or pancreatic cyst. During the follow up period, 6 patients (22%) had cholecystectomy.
Conclusions
In our study of patients with isolated elevations in amylase and/or lipase without acute pancreatitis who underwent EUS, approximately 50% had a pancreatobiliary finding, most commonly chronic pancreatitis or biliary sludge.

Citations

Citations to this article as recorded by

Endosonographic features in patients with non-alcoholic early chronic pancreatitis improved with treatment at one year follow up
Kazutoshi Higuchi, Seiji Futagami, Hiroshi Yamawaki, Makoto Murakami, Kumiko Kirita, Shuhei Agawa, Go Ikeda, Hiroto Noda, Yasuhiro Kodaka, Nobue Ueki, Keiko Kaneko, Katya Gudis, Ryuji Ohashi, Katsuhiko Iwakiri
Journal of Clinical Biochemistry and Nutrition.2021; 68(1): 86. CrossRef
Do Patients with Pancreatic Hyperenzymemia without Abnormal Imaging Need Additional Endoscopic Ultrasound?
Jung Wan Choe, Jong Jin Hyun
Clinical Endoscopy.2019; 52(2): 97. CrossRef

9,525 View
162 Download
3 Web of Science
2 Crossref

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