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Rapid On-Site Evaluation Increases Endoscopic Ultrasound-Guided Fine-Needle Aspiration Adequacy for Pancreatic Lesions

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Abstract

Background

Rapid on-site evaluation (ROSE) has the potential to improve adequacy rates and affect other outcomes; however, there have been few comparative studies to assess the impact of ROSE in the setting of ultrasound-guided endoscopic fine-needle aspiration cytology for pancreatic lesions.

Aims

To determine whether ROSE improves adequacy rates of endoscopic fine-needle aspiration cytology for pancreatic lesions.

Methods

Systematic review and meta-analysis of studies reporting a head-to-head comparison of adequacy or diagnostic accuracy (with ROSE vs. without ROSE) at a single site.

Results

ROSE was associated with a statistically significant (p < 0.001) improvement in the adequacy rate (average 10 %, 95 % CI: 5–24 %). The impact of ROSE depends on the per-pass adequacy rate without ROSE. ROSE had no impact on diagnostic yield (p < 0.76).

Conclusions

ROSE is associated with an improvement in adequacy rates when implemented at sites where the per-case adequacy rate without ROSE is low (<90 %). It is unclear whether the type of assessor (pathologist vs. non-pathologist) has a significant impact on the success rate of ROSE. ROSE has no impact on diagnostic yield. Studies should employ head-to-head comparisons of cohorts with and without ROSE at a single location.

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Authors and Affiliations

  1. Department of Pathology, University of Utah School of Medicine, Salt Lake City, UT, USA

    Robert L. Schmidt, Benjamin L. Witt, Anna P. Matynia, Gonzalo Barraza, Lester J. Layfield & Douglas G. Adler

  2. Gastroenterology Division, Department of Gastroenterology, University of Utah School of Medicine, 30 North 1900, East SOM 4R118, Salt Lake City, UT, 84132-2410, USA

    Robert L. Schmidt, Benjamin L. Witt, Anna P. Matynia, Gonzalo Barraza, Lester J. Layfield & Douglas G. Adler

  3. ARUP Laboratories, Salt Lake City, UT, USA

    Robert L. Schmidt, Benjamin L. Witt, Anna P. Matynia, Gonzalo Barraza & Lester J. Layfield

  4. Department of Surgical Pathology, University of Utah School of Medicine, Salt Lake City, UT, USA

    Lester J. Layfield

  5. Department of Internal Medicine, Division of Gastroenterology, University of Utah School of Medicine, Salt Lake City, UT, USA

    Douglas G. Adler

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  1. Robert L. Schmidt
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Correspondence to Douglas G. Adler.

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Schmidt, R.L., Witt, B.L., Matynia, A.P. et al. Rapid On-Site Evaluation Increases Endoscopic Ultrasound-Guided Fine-Needle Aspiration Adequacy for Pancreatic Lesions. Dig Dis Sci 58, 872–882 (2013). https://doi.org/10.1007/s10620-012-2411-1

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  • DOI: https://doi.org/10.1007/s10620-012-2411-1

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