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Diagnostic Evaluation of Solid Pancreatic Lesions: Endoscopic Ultrasound-Guided Fine Needle Aspiration Versus Percutaneous Ultrasound-Guided Core Needle Biopsy

  • Clinical Investigation
  • Non-Vascular Interventions
  • Published:
CardioVascular and Interventional Radiology Aims and scope Submit manuscript

Abstract

Purpose

The main objective of the present study is to compare the safety, technical success and diagnostic yield of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) versus ultrasound-guided percutaneous core-needle biopsy (US-CNB) in patients with solid pancreatic lesions.

Methods

This is a retrospective study that involved all patients with a solid pancreatic lesion who underwent EUS-FNA or US-CNB between November 2019 and February 2021. Of all patients, 69 (84.1%) had inoperable malignancy, whereas 13 (15.9%) had chronic pancreatitis. Resectability status was ascertained by computed tomography. All core needle biopsies were performed by the same interventional radiologist via ultrasound guidance with an 18-gauge semi-automatic tru-cut needle. All EUS-FNA procedures were performed by the same gastroenterologist with a 27-gauge EUS-FNA needle. Technical success is defined as if the region of interest is reached and specimen taken from the pancreatic lesion. Diagnostic yield is defined as the procurement of sufficient tissue for pathological examination.

Results

Overall, 52 patients (mean age 58.5 ± 9.8 years) who underwent EUS-FNA and 30 patients (60.1 ± 12.1 years) who underwent US-CNB were included. Solid lesions were most commonly (61.5% in EUS-FNA and 50.0% in US-CNB groups) located in pancreatic head in both groups. Mean size of the lesions was comparable in both groups as well. The technical success was 100% in both groups. In 12 (14.6%) patients, pathology results revealed inadequate sampling (11 × in the EUS-FNA and 1 × in the US-CNB group). The diagnostic yield was significantly higher in US-CNB group than in EUS-FNA group (96.7% vs. 78.8%, respectively, p = 0.048). Of 11 patients in the EUS-FNA with inadequate sampling, pancreatic lesions were located in the pancreatic head in 7 (63.6%). No major complications were observed in neither of the groups. As a minor complication, one case of slight abdominal pain was detected in the EUS-FNA group.

Conclusion

Based on the results of the present study, both US-CNB and EUS-FNA appeared safe; however, diagnostic yield in the US-CNB group was significantly higher.

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Data Availability

We added data of the present study with a link*. *https://figshare.com/projects/Diagnostic_Evaluation_of_Solid_Pancreatic_Lesions_Endoscopic_Ultrasound-Guided_Fine_Needle_Aspiration_versus_Ultrasound-Guided_Core_Needle_Biopsy/128942.

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Funding

O.A. was partially supported by the NIH/NCI Cancer Center Support Grant P30 CA008748.

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Authors and Affiliations

  1. Department of Gastroenterology, National Center of Oncology, Baku, Azerbaijan

    Ismail Caymaz & Nargiz Afandiyeva

  2. Istanbul Medeniyet University Goztepe Training and Research Hospital, Eğitim Mahallesi, Doktor Erkin Street, 34722, Kadıköy, Istanbul, Turkey

    Ismail Caymaz

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  1. Ismail Caymaz
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Correspondence to Ismail Caymaz.

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Caymaz, I., Afandiyeva, N. Diagnostic Evaluation of Solid Pancreatic Lesions: Endoscopic Ultrasound-Guided Fine Needle Aspiration Versus Percutaneous Ultrasound-Guided Core Needle Biopsy. Cardiovasc Intervent Radiol 46, 1596–1602 (2023). https://doi.org/10.1007/s00270-023-03494-y

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