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Abstract
Background and Aims
For EUS-guided fine-needle biopsy (EUS-FNB) of solid pancreatic lesions (SPLs), the
role of sampling strategy between a targeted biopsy and wide sampling has not been
reported. This study aimed to investigate the benefits of the two sampling techniques
on EUS-FNB with 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 the secondary
outcomes were overall diagnostic accuracy and complication rates.
Results
A total of 118 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 [1–2]; P = .629). The sensitivity, specificity, and diagnostic accuracy in the contrast and
fanning groups were 100%, 66.7%, and 98.3%, versus 100%, 100%, and 100%, respectively
(P = 1). An SPL size < 4 cm (odds ratio [OR], 2.47; 95% confidence interval [CI], 1.05-5.81;
P = .037) and macroscopic visible core length > 1 cm (OR, 2.89; 95% CI, 1.07-7.84;
P = .037) were independently associated with increased cytologic and histologic accuracy.
Conclusion
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.
Acronyms and abbreviations:
CEH-EUS (contrast-enhanced harmonic endoscopic ultrasound), CI (confidence interval), EUS (endoscopic ultrasound), FNA (fine needle aspiration), FNB (fine needle biopsy), IQR (interquartile range), MOSE (macroscopic on-site evaluation), MVC (macroscopic visible core), OR (odds ratio), PDAC (pancreatic ductal adenocarcinoma), RCT (randomized controlled trial), ROSE (rapid on-site cytologist evaluation), SD (standard deviation), 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
Accepted:
December 1,
2022
Received in revised form:
September 12,
2022
Received:
May 20,
2022
Publication stage
In Press Journal Pre-ProofFootnotes
Author Contributions:
Y-TK and H-PW designed the study. Y-TK and Y-LC prepared the statistical analysis. Y-TK, W-FW, M-LH, C-CC, T-YC, and H-PW recruited patients to the study. Y-TK and Y-LC drafted the article, which was critically revised by H-PW. All authors commented on drafts and approved the final version. All authors had full access to the data and participated in the decision to submit for publication.
Identification
Copyright
© 2022 by the American Society for Gastrointestinal Endoscopy
