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The presence of rapid on-site evaluation did not increase the adequacy and diagnostic accuracy of endoscopic ultrasound-guided tissue acquisition of solid pancreatic lesions with core needle

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Abstract

Background

Rapid on-site evaluation (ROSE) improves the adequacy and accuracy of EUS-guided tissue acquisition, although it is not routinely widely available. Evidence suggested that core needles might overcome the absence of ROSE. The aim of this study was to evaluate the influence of ROSE on the adequacy and accuracy of EUS-guided tissue acquisition with core needles in patients with pancreatic solid lesions.

Methods

Patients who underwent EUS-guided tissue acquisition of pancreatic mass lesions were retrospectively identified at three tertiary referral centers and those performed with the core needle were included. Adequacy, defined as the rate of cases in which a tissue specimen for proper examination was achieved, with and without ROSE was the primary outcome measure. The diagnostic accuracy and tissue core acquisition were the secondary outcome measures.

Results

A total of 333 patients with pancreatic solid mass lesions were included in the study; 140 cases sampled with ROSE and 193 cases without ROSE. The adequacy was 92.1 % in the group sampled with ROSE and 88.1 % in the group without ROSE (p = 0.227). In the ROSE group sensitivity, specificity, and accuracy were 90.7, 100 and 92.1 %, respectively. In the group without ROSE, sensitivity, specificity, and accuracy were 87.2, 100, and 88.1 %, respectively. No difference for all these figures was observed between the two groups. The tissue core was available in 61.4 and 53.4 % of cases with and without ROSE, respectively (p = 0.143).

Conclusion

In the absence of ROSE, EUS-based tissue acquisition with Core needle should be considered since it achieves comparable tissue sampling adequacy and accuracy.

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Abbreviations

EUS-FNA:

Endoscopic ultrasound-guided fine needle aspiration

ROSE:

Rapid on-site evaluation

EUS-FNB:

EUS-guided fine-needle biopsy

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Author contributions

CF was involved in study concept and design; CF, AF, FA, RL, AM, PG, LB, AMP, EI, GM, VC, IT was involved in acquisition of data; LF, LFr, SP was involved in analysis, interpretation of data and statistical analysis; LF was involved in drafting of the manuscript; and CF, LF, AL was involved in critical revision of the manuscript for important intellectual content .

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Authors and Affiliations

  1. Unit of Gastroenterology and Digestive Endoscopy, AUSL Bologna, Bellaria-Maggiore Hospital, 40133, Bologna, Italy

    Carlo Fabbri, Antonella Maimone, Anna Maria Polifemo & Vincenzo Cennamo

  2. Division of Gastroenterology, Department of Medical and Surgical Sciences, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy

    Lorenzo Fuccio & Leonardo Frazzoni

  3. Pathology Service, AUSL Bologna, Bellaria-Maggiore Hospital, Bologna, Italy

    Adele Fornelli

  4. Department of Gastroenterology, A. Murri Hospital, Fermo, Italy

    Filippo Antonini & Giampiero Macarri

  5. Pathology Service, Department of Diagnostic and Therapeutic Services, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (ISMETT), Palermo, Italy

    Rosa Liotta

  6. Digestive Endoscopy Unit, Catholic University, Rome, Italy

    Alberto Larghi

  7. Gastroenterology Unit, Valduce Hospital, Como, Italy

    Silvia Paggi

  8. Pathology Service, A. Murri Hospital, Polytechnic University of Marche, Fermo, Italy

    Paolo Gusella

  9. Endoscopy Service, Department of Diagnostic and Therapeutic Services, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (ISMETT), Palermo, Italy

    Luca Barresi & Ilaria Tarantino

  10. Emergency and General Surgery Department, AUSL Bologna, Bellaria-Maggiore Hospital, Bologna, Italy

    Elio Iovine

Authors
  1. Carlo Fabbri
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  2. Lorenzo Fuccio
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  3. Adele Fornelli
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  4. Filippo Antonini
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  5. Rosa Liotta
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  6. Leonardo Frazzoni
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  7. Alberto Larghi
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  8. Antonella Maimone
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  9. Silvia Paggi
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  10. Paolo Gusella
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  11. Luca Barresi
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  12. Anna Maria Polifemo
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  13. Elio Iovine
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  14. Giampiero Macarri
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  15. Vincenzo Cennamo
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  16. Ilaria Tarantino
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Corresponding author

Correspondence to Carlo Fabbri.

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Nothing to disclose. We did not receive any fund for writing this manuscript.

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Fabbri, C., Fuccio, L., Fornelli, A. et al. The presence of rapid on-site evaluation did not increase the adequacy and diagnostic accuracy of endoscopic ultrasound-guided tissue acquisition of solid pancreatic lesions with core needle. Surg Endosc 31, 225–230 (2017). https://doi.org/10.1007/s00464-016-4960-4

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  • DOI: https://doi.org/10.1007/s00464-016-4960-4

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