Background and Aims
For EUS-guided fine-needle biopsy sampling (EUS-FNB) of solid pancreatic lesions (SPLs),
the role of sampling strategy between targeted biopsy sampling and wide sampling has
not been reported. This study aimed to investigate the benefits of the 2 sampling
techniques on EUS-FNB using rapid on-site evaluation.
Methods
Patients with SPLs were prospectively enrolled and randomly assigned (1:1) to undergo
EUS-FNB using either contrast guidance or the fanning technique. The primary outcome
was the total number of passes required to establish a diagnosis, and secondary outcomes
were overall diagnostic accuracy and adverse event rates.
Results
One hundred eighteen patients were enrolled from February 2019 to January 2021, with
59 patients assigned to each group. There was no significant difference in the total
number of passes required to establish a diagnosis between the contrast and fanning
groups (median, 1 [interquartile range, 1-1] vs 1 [interquartile range, 1-2], respectively;
P = .629). The sensitivity, specificity, and diagnostic accuracy in the contrast group
was 100%, 66.7%, and 98.3% and in the fanning group 100%, 100%, and 100%, respectively
(P = 1). An SPL <4 cm (odds ratio, 2.47; 95% confidence interval, 1.05-5.81; P = .037) and macroscopic visible core length >1 cm (odds ratio, 2.89; 95% confidence
interval, 1.07-7.84; P = .037) were independently associated with increased cytologic and histologic accuracy.
Conclusions
The diagnostic accuracy of EUS-FNB with the fanning technique for SPLs was comparable
with the contrast guidance technique. Without additional cost, EUS-FNB with the fanning
technique may be preferred for SPLs. (Clinical trial registration number: NCT04924725.)
Abbreviations:
CEH-EUS (contrast-enhanced harmonic EUS), FNB (fine-needle biopsy sampling), IQR (interquartile range), MVC (macroscopic visible core), RCT (randomized controlled trial), ROSE (rapid on-site cytologist evaluation), SPL (solid pancreatic lesion)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: December 09, 2022
Accepted:
December 1,
2022
Received:
May 20,
2022
Footnotes
DISCLOSURE: All authors disclosed no financial relationships.
DIVERSITY, EQUITY, AND INCLUSION: The author list of this paper includes contributors from the location where the research was conducted who participated in the data collection, design, analysis, and/or interpretation of the work.
Identification
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© 2023 by the American Society for Gastrointestinal Endoscopy
