Background and Aims
FNA is the primary method of EUS tissue acquisition. In an attempt to improve our
yield of EUS-guided tissue acquisition, we compared fine-needle biopsy (FNB) sampling
without rapid onsite evaluation (ROSE) with FNA with ROSE and assessed the concordance
of FNA and FNB sampling.
Methods
This was a retrospective review of prospectively collected data from consecutive patients.
Patients underwent FNB sampling and FNA of the same single lesion, with the same needle
gauge and number of passes. FNA with ROSE was performed with a standard FNA needle.
FNB sampling was performed with a new dedicated core needle. FNA samples were assessed
with ROSE, and a final interpretation was provided by cytopathology staff; FNB samples
were analyzed by surgical pathologists, each not made aware of the other’s opinion.
Results
Thirty-three patients underwent 312 passes in 42 different lesions. A diagnosis of
malignancy was more likely with FNB sampling than with FNA (72.7% vs 66.7%, P = .727), although statistical significance was not reached. FNA and FNB sampling
had similar sensitivities, specificities, and accuracies for cancer (81.5% vs 88.9%,
100% vs 100%, and 84.8% vs 90.9%, respectively). FNB sampling provided qualitative
information not reported on FNA, such as degree of differentiation in malignancy,
metastatic origin, and rate of proliferation in neuroendocrine tumors.
Conclusions
FNB sampling without ROSE using a dedicated core needle performed as well as FNA with
ROSE in this small cohort, suggesting that FNB sampling with this new core needle
may eliminate the need for an onsite cytopathologic assessment, without loss of diagnostic
accuracy.
Abbreviations:
FNB (fine-needle biopsy), ROSE (rapid onsite evaluation)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: June 23, 2016
Accepted:
June 14,
2016
Received:
January 10,
2016
Footnotes
DISCLOSURE: The following authors disclosed financial relationships relevant to this publication: I. S. Grimm: Consultant for Boston Scientific; T. H. Baron: Consultant for Boston Scientific and Olympus. All other authors disclosed no financial relationships relevant to this publication.
If you would like to chat with an author of this article, you may contact Dr Baron at [email protected]
Identification
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Copyright © 2016 by the American Society for Gastrointestinal Endoscopy
