Clinical Endoscopy

Effectiveness of endoscopic ultrasound-guided tissue acquisition with stereomicroscopic on-site evaluation for preoperative diagnosis of resectable or borderline resectable pancreatic cancer: a prospective study: Junro Ishizaki, Kosuke Okuwaki, Masafumi Watanabe, Hiroshi Imaizumi, Tomohisa Iwai, Rikiya Hasegawa, Takahiro Kurosu, Masayoshi Tadehara, Takaaki Matsumoto, Kai Adachi, Taro Hanaoka, Mitsuhiro Kida, Chika Kusano; Received October 25, 2023 Accepted January 15, 2024 Published online May 24, 2024; DOI: https://doi.org/10.5946/ce.2023.277 [Epub ahead of print]

Graphical Abstract Abstract PDF PubReader ePub: Background
/Aims: To validate endoscopic ultrasound-guided tissue acquisition (EUS-TA) used in conjunction with stereomicroscopic on-site evaluation (SOSE) as a preoperative diagnostic tool for resectable pancreatic cancer (R-PC) and borderline resectable PC (BR-PC).
Methods
Seventy-eight consecutive patients who underwent EUS-TA for suspected R-PC or BR-PC were enrolled. The primary endpoint was the sensitivity of EUS-TA together with SOSE based on the stereomicroscopically visible white core (SVWC) cutoff value. One or two sites were punctured by using a 22-gauge biopsy needle for EUS-TA, based on the SOSE findings.
Results
We collected 99 specimens from 56 and 22 patients with R-PC and BR-PC, respectively. Based on the SOSE results, we performed 57 procedures with one puncture. The SVWC cutoff values were met in 73.7% and 73.1% of all specimens and in those obtained during the first puncture, respectively. The final diagnoses were malignant and benign tumors in 76 and two patients, respectively. The overall sensitivity, specificity, and accuracy of EUS-TA for the 78 lesions were 90.8%, 100%, and 91.0%, respectively. The sensitivity for malignant diagnosis based on the SVWC cutoff value were 89.5% and 90.4% for the first puncture and all specimens, respectively.
Conclusions
The sensitivity of EUS-TA in conjunction with SOSE for malignancy diagnosis in patients with suspected R-PC or BR-PC was 90.4%.

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22-gauge Co-Cr versus stainless-steel Franseen needles for endoscopic ultrasound-guided tissue acquisition in patients with solid pancreatic lesions: Yuki Tanisaka, Masafumi Mizuide, Akashi Fujita, Ryuhei Jinushi, Rie Shiomi, Takahiro Shin, Kei Sugimoto, Tomoaki Tashima, Yumi Mashimo, Shomei Ryozawa; Clin Endosc 2024;57(2):237-245. Published online January 26, 2024; DOI: https://doi.org/10.5946/ce.2023.011

Graphical Abstract Abstract PDF PubReader ePub: Background
/Aims: Endoscopic ultrasound-guided tissue acquisition (EUS-TA) using Franseen needles is reportedly useful for its high diagnostic yield. This study compared the diagnostic yield and puncturing ability of EUS-TA using 22-gauge cobalt-chromium (CO-Cr) needles with those of stainless-steel Franseen needles in patients with solid pancreatic lesions.
Methods
Outcomes were compared between the 22-gauge Co-Cr Franseen needle (December 2019 to November 2020; group C) and stainless-steel needle (November 2020 to May 2022; group S).
Results
A total of 155 patients (group C, 75; group S, 80) were eligible. The diagnostic accuracy was 92.0% in group C and 96.3% in group S with no significant intergroup differences (p=0.32). The rate of change in the operator (from training fellows to experts) was 20.0% (15/75) in group C and 7.5% (6/80) in group S. Stainless-steel Franseen needles showed less inter-operator difference than Co-Cr needles (p=0.03).
Conclusions
Both Co-Cr and stainless-steel Franseen needles showed high diagnostic ability. Stainless-steel Franseen needles are soft and flexible; therefore, the range of puncture angles can be widely adjusted, making them suitable for training fellows to complete the procedure.

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Comparison of 19-gauge conventional and Franseen needles for the diagnosis of lymphadenopathy and classification of malignant lymphoma using endoscopic ultrasound fine-needle aspiration: Mitsuru Okuno, Keisuke Iwata, Tsuyoshi Mukai, Yusuke Kito, Takuji Tanaka, Naoki Watanabe, Senji Kasahara, Yuhei Iwasa, Akihiko Sugiyama, Youichi Nishigaki, Yuhei Shibata, Junichi Kitagawa, Takuji Iwashita, Eiichi Tomita, Masahito Shimizu; Clin Endosc 2024;57(3):364-374. Published online September 8, 2023; DOI: https://doi.org/10.5946/ce.2023.095

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Background
/Aims: Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) using a 19-gauge needle is an efficient sampling method for the diagnosis of lymphadenopathy. This study compared 19-gauge conventional and Franseen needles for the diagnosis of lymphadenopathy and classification of malignant lymphoma (ML).
Methods
Patient characteristics, number of needle passes, puncture route, sensitivity, specificity, and accuracy of cytology/histology for lymphadenopathy were analyzed in patients diagnosed with lymphadenopathy by EUS-FNA using conventional or Franseen needles.
Results
Between 2012 and 2022, 146 patients met the inclusion criteria (conventional [n=70] and Franseen [n=76]). The median number of needle passes was significantly lower in the conventional group than in the Franseen group (3 [1–6] vs. 4 [1–6], p=0.023). There were no significant differences in cytological/histological diagnoses between the two groups. For ML, the immunohistochemical evaluation rate, sensitivity of flow cytometry, and cytogenetic assessment were not significantly different in either group. Bleeding as adverse events (AEs) were observed in three patients in the Franseen group.
Conclusions
Both the 19-gauge conventional and Franseen needles showed high accuracy in lymphadenopathy and ML classification. Considering sufficient tissue collection and the avoidance of AEs, the use of 19-gauge conventional needles seems to be a good option for the diagnosis of lymphadenopathy.

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Choosing needles wisely: 19-G conventional vs. Franseen needles in endoscopic ultrasound-guided fine-needle aspiration for malignant lymphoma diagnosis and classification
Kajornvit Raghareutai, Worapoth Yingyongthawat, Nonthalee Pausawasdi
Clinical Endoscopy.2024; 57(4): 473. CrossRef

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Stereomicroscopic on-site evaluation in endoscopic ultrasound-guided tissue acquisition of upper gastrointestinal subepithelial lesions: Seigo Nakatani, Kosuke Okuwaki, Masafumi Watanabe, Hiroshi Imaizumi, Tomohisa Iwai, Takaaki Matsumoto, Rikiya Hasegawa, Hironori Masutani, Takahiro Kurosu, Akihiro Tamaki, Junro Ishizaki, Ayana Ishizaki, Mitsuhiro Kida, Chika Kusano; Clin Endosc 2024;57(1):89-95. Published online April 18, 2023; DOI: https://doi.org/10.5946/ce.2022.288

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Background
/Aims: In stereomicroscopic sample isolation processing, the cutoff value (≥4 mm) of stereomicroscopically visible white cores indicates high diagnostic sensitivity. We aimed to evaluate endoscopic ultrasound-guided tissue acquisition (EUS-TA) using a simplified stereomicroscopic on-site evaluation of upper gastrointestinal subepithelial lesions (SELs).
Methods
In this multicenter prospective trial, we performed EUS-TA using a 22-gauge Franseen needle in 34 participants with SELs derived from the upper gastrointestinal muscularis propria, requiring pathological diagnosis. The presence of stereomicroscopically visible white core (SVWC) in each specimen was assessed using stereomicroscopic on-site evaluation. The primary outcome was EUS-TA’s diagnostic sensitivity with stereomicroscopic on-site evaluation based on the SVWC cutoff value (≥4 mm) for malignant upper gastrointestinal SELs.
Results
The total number of punctures was 68; 61 specimens (89.7%) contained stereomicroscopically visible white cores ≥4 mm in size. The final diagnoses were gastrointestinal stromal tumor, leiomyoma, and schwannoma in 76.5%, 14.7%, and 8.8% of the cases, respectively. The sensitivity of EUS-TA with stereomicroscopic on-site evaluation based on the SVWC cutoff value for malignant SELs was 100%. The per-lesion accuracy of histological diagnosis reached the highest level (100%) at the second puncture.
Conclusions
Stereomicroscopic on-site evaluation showed high diagnostic sensitivity and could be a new method for diagnosing upper gastrointestinal SELs using EUS-TA.

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What method can we choose if rapid on-site evaluation is not available for the endoscopic ultrasound-guided tissue acquisition of upper gastrointestinal subepithelial lesions?
Yu Kyung Cho
Clinical Endoscopy.2024; 57(1): 53. CrossRef
Endoscopic Ultrasound-Guided Tissue Acquisition Using Fork-Tip Needle for Subepithelial Lesions: A Single-Center Validation Study
Masafumi Watanabe, Kosuke Okuwaki, Tomohisa Iwai, Mitsuhiro Kida, Hiroshi Imaizumi, Kai Adachi, Akihiro Tamaki, Junro Ishizaki, Taro Hanaoka, Chika Kusano
Digestive Diseases and Sciences.2024; 69(7): 2567. CrossRef
Impact of macroscopic on-site evaluation (MOSE) on accuracy of endoscopic ultrasound-guided fine-needle aspiration/biopsy of solid lesions
Hussein Okasha, Ahmed Ebrahim, Ihab Samih, Mohammed Sayed
International Journal of Gastrointestinal Intervention.2024; 13(3): 98. CrossRef
An Esophageal Leiomyoma with Cystic Degeneration Mimicking a Malignant Neoplasm
Gwang Ha Kim, Dong Chan Joo, Moon Won Lee, Bong Eun Lee, Kyungbin Kim
The Ewha Medical Journal.2023;[Epub] CrossRef

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A multicenter comparative study of endoscopic ultrasound-guided fine-needle biopsy using a Franseen needle versus conventional endoscopic ultrasound-guided fine-needle aspiration to evaluate microsatellite instability in patients with unresectable pancreatic cancer: Tadayuki Takagi, Mitsuru Sugimoto, Hidemichi Imamura, Yosuke Takahata, Yuki Nakajima, Rei Suzuki, Naoki Konno, Hiroyuki Asama, Yuki Sato, Hiroki Irie, Jun Nakamura, Mika Takasumi, Minami Hashimoto, Tsunetaka Kato, Ryoichiro Kobashi, Yuko Hashimoto, Goro Shibukawa, Shigeru Marubashi, Takuto Hikichi, Hiromasa Ohira; Clin Endosc 2023;56(1):107-113. Published online January 16, 2023; DOI: https://doi.org/10.5946/ce.2022.019

Abstract PDF PubReader ePub

Background
/Aims: Immune checkpoint blockade has recently been reported to be effective in treating microsatellite instability (MSI)-high tumors. Therefore, sufficient sampling of histological specimens is necessary in cases of unresectable pancreatic cancer (UR-PC). This multicenter study investigated the efficacy of endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) using a Franseen needle for MSI evaluation in patients with UR-PC.
Methods
A total of 89 patients with UR-PC who underwent endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) or EUS-FNB using 22-G needles at three hospitals in Japan (2018–2021) were enrolled. Fifty-six of these patients (FNB 23 and FNA 33) were followed up or evaluated for MSI. Patient characteristics, UR-PC data, and procedural outcomes were compared between patients who underwent EUS-FNB and those who underwent EUS-FNA.
Results
No significant difference in terms of sufficient tissue acquisition for histology was observed between patients who underwent EUS-FNB and those who underwent EUS-FNA. MSI evaluation was possible significantly more with tissue samples obtained using EUS-FNB than with tissue samples obtained using EUS-FNA (82.6% [19/23] vs. 45.5% [15/33], respectively; p<0.01). In the multivariate analysis, EUS-FNB was the only significant factor influencing the possibility of MSI evaluation.
Conclusions
EUS-FNB using a Franseen needle is desirable for ensuring sufficient tissue acquisition for MSI evaluation.

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Oil blotting paper for formalin fixation increases endoscopic ultrasound‐guided tissue acquisition‐collected sample volumes on glass slides
Takuo Yamai, Kenji Ikezawa, Yusuke Seiki, Ko Watsuji, Yasuharu Kawamoto, Takeru Hirao, Kazuma Daiku, Shingo Maeda, Makiko Urabe, Yugo Kai, Ryoji Takada, Kaori Mukai, Tasuku Nakabori, Hiroyuki Uehara, Sayoko Tsuzaki, Ayumi Ryu, Satoshi Tanada, Shigenori Na
Cancer Medicine.2024;[Epub] CrossRef
Lymphadenopathy Tissue Sampling by EUS-Guided Fine-Needle Biopsy Contributes to Meeting the Conditions for Genomic Profiling
Mitsuru Sugimoto, Tadayuki Takagi, Rei Suzuki, Naoki Konno, Hiroyuki Asama, Yuki Sato, Hiroki Irie, Jun Nakamura, Mika Takasumi, Minami Hashimoto, Tsunetaka Kato, Yuko Hashimoto, Takuto Hikichi, Hiromasa Ohira
Journal of Clinical Gastroenterology.2024;[Epub] CrossRef

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Endoscopic Ultrasound-Guided Transgastric Puncture and Drainage of an Adrenal Abscess in an Immunosuppressed Patient: Carlos Andrés Regino, Jean Paul Gómez, Gabriel Mosquera-Klinger; Clin Endosc 2022;55(2):302-304. Published online November 16, 2021; DOI: https://doi.org/10.5946/ce.2021.090

Abstract PDF PubReader ePub: Adrenal gland infection is a clinical entity of great importance, but it is a largely unrecognized pathology. Immunosuppressed individuals are at a higher risk of presentation. Herein, we describe a young female patient, recently diagnosed with HIV, who presented with severe sepsis due to methicillin-resistant Staphylococcus aureus, associated with a left adrenal abscess. She was initially treated with antibiotics; however, due to the persistence of the systemic inflammatory response and bacteremia, endoscopic ultrasound-guided drainage was performed. This procedure was successful in resolving the clinical situation. Endoscopic ultrasound-guided adrenal gland drainage can be a safe, efficacious, and minimally invasive option for managing antibiotic-refractory adrenal abscesses in immunosuppressed patients.

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Feasibility and Accuracy of Transduodenal Endoscopic Ultrasound-Guided Fine-Needle Aspiration of Solid Lesions Using a 19-Gauge Flexible Needle: A Multicenter Study: Germana de Nucci, Maria Chiara Petrone, Nicola Imperatore, Edoardo Forti, Roberto Grassia, Silvia Giovanelli, Laura Ottaviani, Vincenzo Mirante, Giuseppe Sabatino, Carlo Fabbri, Mauro Manno, Paolo Giorgio Arcidiacono, Gianpiero Manes; Clin Endosc 2021;54(2):229-235. Published online May 25, 2020; DOI: https://doi.org/10.5946/ce.2020.056

Abstract PDF PubReader ePub

Background
/Aims: Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is the go-to method for obtaining samples from gastrointestinal tract and pancreatic lesions. When the transduodenal approach is utilized, the use of a more flexible needle, such as a nitinol 19-gauge (G) needle, has been recommended. The aim of this study was to evaluate the feasibility and accuracy of 19-G flexible aspiration needles in obtaining samples from solid lesions through a transduodenal approach.
Methods
This was a retrospective analysis of prospectively collected data from eight Italian endoscopy centers. Consecutive patients with solid lesions who underwent transduodenal EUS-FNA with a 19-G flexible needle were included.
Results
A total of 201 patients were enrolled. According to histology, EUS, radiology and 12 months of follow-up, 151 patients had malignant lesions and 50 patients had benign lesions. EUS-FNA was feasible in all cases. An adequate histologic sample was obtained in all except eight cases (96.1%). The sensitivity of EUS-FNA was 92.1% (95% confidence interval [CI], 86.8%–95.7%), and the specificity was 100% (95% CI, 90.5%–100%). The positive predictive value was 100% (95% CI, 93.4%–100%), and the negative predictive value was 74% (95% CI, 62.8%–82.7%). The diagnostic accuracy was 93.5% (95% CI, 89.2%–96.5%).
Conclusions
The transduodenal approach for obtaining samples from solid lesions using a 19-G flexible needle seems feasible and accurate.

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Comparation of 5 ml and 10 ml Negative Pressures with Wet-suction Techniques for EUS-FNA of Solid Lesions
Yuchun Zhu, Yang Su, Peng Yang, Jiaojun Li, Tai Yu, Yi Wang, Xi Zhou, Ming Zhao, Xiaobin Sun, Jing Shan
Journal of Clinical Gastroenterology.2024;[Epub] CrossRef
Diagnostic Ability of Endoscopic Ultrasound-Guided Tissue Acquisition Using 19-Gauge Fine-Needle Biopsy Needle for Abdominal Lesions
Kotaro Takeshita, Susumu Hijioka, Yoshikuni Nagashio, Yuta Maruki, Yuki Kawasaki, Kosuke Maehara, Yumi Murashima, Mao Okada, Go Ikeda, Natsumi Yamada, Tetsuro Takasaki, Daiki Agarie, Hidenobu Hara, Yuya Hagiwara, Kohei Okamoto, Daiki Yamashige, Akihiro Oh
Diagnostics.2023; 13(3): 450. CrossRef
Effect of wet-heparinized suction on the quality of mediastinal solid tumor specimens obtained by endoscopic ultrasound-guided fine-needle aspiration: a retrospective study from a single center
Bo Xu, Qian Lu, Rong Fang, Xiaojuan Dai, Haiyan Xu, Xiangwu Ding, Huawei Gui
BMC Gastroenterology.2023;[Epub] CrossRef
Comparison of Endoscopic Ultrasound-Guided Fine Needle Aspiration with 19-Gauge and 22-Gauge Needles for Solid Pancreatic Lesions
Changjuan Li, Jianwei Mi, Fulai Gao, Xinying Zhu, Miao Su, Xiaoli Xie, Dongqiang Zhao
International Journal of General Medicine.2021; Volume 14: 10439. CrossRef

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Present and Future of Endoscopic Ultrasound-Guided Tissue Acquisition in Solid Pancreatic Tumors: Jae Keun Park, Kwang Hyuck Lee; Clin Endosc 2019;52(6):541-548. Published online November 29, 2019; DOI: https://doi.org/10.5946/ce.2019.127

Abstract PDF PubReader ePub

Endoscopic ultrasound-guided tissue acquisition (EUS-TA) is a well-established method for pathological diagnosis of solid pancreatic neoplasm. It can be performed either as EUS-guided fine-needle aspiration (EUS-FNA) or EUS-guided fine-needle biopsy (EUSFNB). The incidence of adverse events related to EUS-TA is less than 1%. The factors that affect the diagnostic accuracy and specimen adequacy include the techniques used, type and size of the needle, competency of endosonographers, presence of cytopathologists/ cytotechnologists, and rapid on-site examination. EUS-TA may contribute to precision medicine through obtaining tissue samples for next-generation sequencing. The current status, several clinical issues for diagnostic yield and adverse events, and future perspectives of EUS-FNA/FNB for diagnosing pancreatic neoplasm have been discussed in this review article.

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Diagnostic performance of EUS-guided tissue acquisition for solid pancreatic lesions ≤10 mm
Yuki Kawasaki, Susumu Hijioka, Yoshikuni Nagashio, Akihiro Ohba, Yuta Maruki, Kotaro Takeshita, Tetsuro Takasaki, Daiki Agarie, Yuya Hagiwara, Hidenobu Hara, Kohei Okamoto, Daiki Yamashige, Shunsuke Kondo, Chigusa Morizane, Hideki Ueno, Takahiro Mizui, Ta
Endoscopic Ultrasound.2024;[Epub] CrossRef
A combination of faecal and intratumour microbial community profiling reveals novel diagnostic and prognostic biomarkers for pancreatic tumours
Wei Wang, Cheng Qian, Ting Wang, Yuetong Jiang, Yiran Zhou, Kaiyu Liu, Zhiyang Ma, Pengyi Liu, Yichi Wu, Leying Chen, Huaizhi Wang, Tingting Zhou
Clinical and Translational Medicine.2024;[Epub] CrossRef
Molecular Characterization and Xenotransplantation of Pancreatic Cancer Using Endoscopic Ultrasound-Guided Fine Needle Aspiration (EUS-FNA)
Lilia Antonova, Piriya Paramanthan, Theresa Falls, Marie-Eve Wedge, Justin Mayer, Harman S. Sekhon, John McPherson, Robert E. Denroche, Steven Gallinger, John Cameron Bell, Carolina S. Ilkow, Avijit Chatterjee
Cancers.2024; 16(15): 2721. CrossRef
How to optimize the diagnostic yield of endoscopic ultrasound-guided fine-needle sampling in solid pancreatic lesions from a technical perspective
Nam Hee Kim, Hong Joo Kim
International Journal of Gastrointestinal Intervention.2023; 12(2): 57. CrossRef
Efficacy of endoscopic ultrasound-guided tissue acquisition for solid pancreatic lesions 20 mm or less in diameter suspected as neuroendocrine tumors or requiring differentiation
Yuki Kawasaki, Susumu Hijioka, Yoshikuni Nagashio, Yuta Maruki, Akihiro Ohba, Kotaro Takeshita, Tetsuro Takasaki, Daiki Agarie, Yuya Hagiwara, Hidenobu Hara, Kohei Okamoto, Daiki Yamashige, Shunsuke Kondo, Chigusa Morizane, Hideki Ueno, Takahiro Mizui, Ta
Journal of Gastroenterology.2023; 58(7): 693. CrossRef
Performance of EUS-FNB in solid pancreatic masses: a lesson from 463 consecutive procedures and a practical nomogram
Nico Pagano, Claudio Ricci, Carlo Ingaldi, Sinan Sadalla, Andrea Fabbri, Laura Alberici, Giovanna Impellizeri, Socrate Pallio, Rocco Maurizio Zagari, Antonio De Leo, Matteo Cescon, Riccardo Casadei
Updates in Surgery.2022; 74(3): 945. CrossRef
Diagnostic Value and Influencing Factors of EUS-FNA in Pancreatic Solid Masses
培君任
Advances in Clinical Medicine.2022; 12(05): 3931. CrossRef
Diagnostic performance of endoscopic ultrasound-guided tissue acquisition by EUS-FNA versus EUS-FNB for solid pancreatic mass without ROSE: a retrospective study
Thanawin Wong, Tanawat Pattarapuntakul, Nisa Netinatsunton, Bancha Ovartlarnporn, Jaksin Sottisuporn, Naichaya Chamroonkul, Pimsiri Sripongpun, Sawangpong Jandee, Apichat Kaewdech, Siriboon Attasaranya, Teerha Piratvisuth
World Journal of Surgical Oncology.2022;[Epub] CrossRef
Safety and Efficacy of Ultrasound-Guided Percutaneous Core Needle Biopsy of Pancreatic and Peripancreatic Lesions Adjacent to Critical Vessels
Sun Hwa Chung, Hyun Ji Kang, Hyo Jeong Lee, Jin Sil Kim, Jeong Kyong Lee
Journal of the Korean Society of Radiology.2021; 82(5): 1207. CrossRef

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A “Back Light System” for Identification of Sites for Endoscopic Ultrasound-Guided Fine-Needle Aspiration in Solid Pancreatic Masses: A Prospective, Randomized Study with a Crossover Design: Ryo Harada, Hironari Kato, Soichiro Fushimi, Hirofumi Inoue, Daisuke Uchida, Yutaka Akimoto, Takeshi Tomoda, Kazuyuki Matsumoto, Yasuhiro Noma, Naoki Yamamoto, Shigeru Horiguchi, Koichiro Tsutsumi, Hiroyuki Okada; Clin Endosc 2019;52(4):334-339. Published online May 16, 2019; DOI: https://doi.org/10.5946/ce.2019.004

Abstract PDF PubReader ePub

Background
/Aims: We applied a back light system (BLS) with a magnifying glass to improve the ability to assess the adequacy of specimen sampling using endosonography. We conducted this study to evaluate the efficacy of the BLS in sampling of specimens by endoscopic ultrasound-guided fine needle aspiration of solid pancreatic masses.
Methods
This was a prospective, randomized, crossover, single-center clinical trial. An endosonographer evaluated adequacy on gross visual inspection and identified whitish specimen sampling sites with and without the BLS according to a randomization sequence in the first and second passes with a 25-G needle. On cytological evaluation, the presence of well-defined pancreatic ductal epithelium was evaluated by a cytopathologist who was blinded to any clinical information.
Results
A total of 80 consecutive patients were eligible during the study period. Adequacy was observed for 52 specimens (65%) with the BLS and 54 (68%) without the BLS (p=0.88). In assessment of specimen adequacy on gross examination, only fair agreement was observed both with and without BLS (kappa score 0.40 and 0.29, respectively).
Conclusions
The BLS did not influence the ability to identify specimen sampling sites or reliable assessment of specimen site adequacy using gross visual inspection.

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Tissue processing of endoscopic ultrasound-guided fine-needle aspiration specimens from solid pancreatic lesions
Kenji Notohara, Kaori Nakamura
Journal of Medical Ultrasonics.2024; 51(2): 261. CrossRef
Macroscopic qualitative evaluation of solid pancreatic lesion specimens from endoscopic ultrasound-guided fine needle aspiration/biopsies
Kaori Nakamura, Kenji Notohara, Ryoji Nishizaki, Etsuji Ishida, Midori Sato, Akemi Kodera, Junya Itakura, Motowo Mizuno
Pancreatology.2023; 23(8): 1028. CrossRef
Unfortunately, a “Back Light System” As a Global Positioning System Failed to Guide the Route in 25-G Fine-Needle Aspiration
Rungsun Rerknimitr, Phonthep Angsuwatcharakon
Clinical Endoscopy.2019; 52(4): 295. CrossRef

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Fine-Needle Biopsy: Should This Be the First Choice in Endoscopic Ultrasound-Guided Tissue Acquisition?: Eun Young Kim; Clin Endosc 2014;47(5):425-428. Published online September 30, 2014; DOI: https://doi.org/10.5946/ce.2014.47.5.425

Abstract PDF PubReader ePub

Endoscopic ultrasound (EUS)-guided tissue acquisition is an indispensable technique for the diagnosis of many diseases of the gastrointestinal tract and adjacent structures. EUS-guided fine-needle aspiration (EUS-FNA) is known for its high accuracy and low complication rate. However, the outcome of EUS-FNA highly depends on several factors such as the location and characteristics of the lesion, endosonographer's experience, technique of sampling and sample preparation, type and size of the needle used, and presence of a cytopathologist for rapid on-site examination. EUS-guided fine-needle biopsy is useful to obtain core tissue samples with relatively fewer passes. Aspiration of core tissue with preserved architecture is beneficial for the diagnosis of certain diseases and the performance of ancillary testing such as tumor molecular profiling. Issues related to needle size, type, and their acquired samples for cytologic and histologic evaluation are discussed here.

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