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Ultrasound-guided percutaneous fine-needle aspiration of solid pancreatic neoplasms: 10-year experience with more than 2,000 cases and a review of the literature

  • Hepatobiliary-Pancreas
  • Published:
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Abstract

Objectives

To evaluate the diagnostic accuracy and complication rate of percutaneous ultrasound-guided fine-needle aspiration (US-FNA) of solid pancreatic neoplasms through the analysis of 10-year experiences of two centres.

Methods

Clinical, radiological and pathologic data of 2,024 patients with solid pancreatic masses who underwent US-FNAs were retrospectively evaluated. Indications for aspiration were: unresectable lesions before neo-adjuvant therapy; doubtful imaging findings; and suspicion of uncommon neoplasms with prognostic or therapeutic implications such as metastases or lymphoma. US-FNAs were performed using aspiration needles with a cytopathologist present in centre 1. In centre 2, cytologic samples were collected with Chiba needles and separately evaluated by a cytopathologist.

Results

US-FNA had a diagnostic sample rate of 92.2 % (centre 1: 95.9 %; centre 2: 87.2 %). US-FNA repetition after non-diagnostic samples provided a diagnosis in 86.3 % of cases. Sensitivity, specificity, positive and negative predictive values, and accuracy were 98.7 %, 100 %, 100 %, 75.5 %, and 98.7 %, respectively. The complication rate was 0.8 %.

Conclusions

Percutaneous US-FNA is a sensitive, accurate and safe method for the invasive diagnosis of solid pancreatic neoplasms. The use of aspiration needles and the on-site presence of a cytopathologist may lead to a high rate of diagnostic samples, thus reducing the need for US-FNA repetition.

Key Points

• Percutaneous ultrasound-guided fine-needle aspiration of pancreatic neoplasms is sensitive and accurate.

• The short-term complication rate of percutaneous ultrasound-guided fine-needle aspiration is low.

• Technical aspects may influence the rate of diagnostic samples.

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Acknowledgments

The scientific guarantor of this publication is Roberto Pozzi Mucelli. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. No complex statistical methods were necessary for this paper. Institutional review board approval was not required due to the retrospective nature of the study. Written informed consent was obtained from all subjects (patients) in this study. A total of 544 study subjects were previously reported in Zamboni GA et al., AJR 2009; 193:1691–1695.

Methodology: retrospective, observational, multicentre study.

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Authors and Affiliations

  1. Department of Radiology, G.B. Rossi Hospital, University of Verona, Piazzale L.A. Scuro 10, 37134, Verona, Italy

    Mirko D’Onofrio, Enrico Martone, Gino Puntel & Roberto Pozzi Mucelli

  2. Department of Radiology, Casa di cura Pederzoli, Peschiera del Garda, Italy

    Riccardo De Robertis & Emilio Barbi

  3. Department of Pathology, G.B. Rossi Hospital, University of Verona, Verona, Italy

    Erminia Manfrin & Franco Bonetti

  4. Department of Pathology, Casa di cura Pederzoli, Peschiera del Garda, Italy

    Stefano Gobbo

Authors
  1. Mirko D’Onofrio
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  2. Riccardo De Robertis
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  3. Emilio Barbi
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  4. Enrico Martone
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  5. Erminia Manfrin
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  6. Stefano Gobbo
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  7. Gino Puntel
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  8. Franco Bonetti
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  9. Roberto Pozzi Mucelli
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Correspondence to Riccardo De Robertis.

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D’Onofrio, M., De Robertis, R., Barbi, E. et al. Ultrasound-guided percutaneous fine-needle aspiration of solid pancreatic neoplasms: 10-year experience with more than 2,000 cases and a review of the literature. Eur Radiol 26, 1801–1807 (2016). https://doi.org/10.1007/s00330-015-4003-x

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  • DOI: https://doi.org/10.1007/s00330-015-4003-x

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