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Diagnostic value of SpyGlass for pancreatic cystic lesions: comparison of EUS-guided fine-needle aspiration and EUS-guided fine-needle aspiration combined with SpyGlass

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Abstract

Background and aims

No study has evaluated the diagnostic value of SpyGlass by comparing SpyGlass results and non-SpyGlass results. In this retrospective study, we aimed to compare the diagnostic value of EUS-guided fine-needle aspiration (EUS-FNA) and EUS-FNA combined with SpyGlass to evaluate whether SpyGlass is valuable for increasing the diagnostic yield of EUS-FNA.

Methods

From April 2015 to April 2020, 251 patients suspected of having pancreatic cystic lesions (PCLs) by imaging techniques who then underwent EUS-FNA were retrospectively enrolled. Only 98 patients who underwent surgical resection with a pathological diagnosis of pancreatic cystic lesion (PCL) were studied. The diagnostic performance outcomes were compared between the EUS-FNA group (EUS-FNA alone, n = 40) and the SpyGlass group (EUS-FNA combined with SpyGlass, n = 58) to assess the value of SpyGlass in diagnosing PCLs.

Results

There were 71 females and 27 males with an overall mean age of 47.6 years. The median diameter of the PCLs was 42.2 mm (range, 11.4–100.0 mm). Approximately 37 cysts were localized in the head/neck of the pancreas, while 61 in the body/tail. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of the EUS-FNA group were 96.4% (27/28), 83.3% (10/12), 93.1% (27/29), 90.9% (10/11) and 92.5% (37/40), while those in the SpyGlass group were 100% (54/54), 75% (3/4), 98.2% (54/55), 100% (3/3) and 98.3% (57/58), respectively. The diagnostic accuracy rate in the SpyGlass group was higher than that in the EUS-FNA group; however, no significant difference was found between the two groups (P = 0.368). The diagnostic accuracy of evaluating specific cyst types in the EUS-FNA group was 85% (34/40), similar to that in the SpyGlass group (85.0% vs 84.5%, P = 0.944).

Conclusion

SpyGlass seems less valuable for the diagnosis of PCLs when EUS and EUS-FNA have been performed by experienced endoscopists.

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Acknowledgements

This study was supported by two research grants from National Key R&D Programs of China (2016YFC1303601 and 2020YFC2002705).

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  1. Chen Du and Ningli Chai have contributed equally to this work.

Authors and Affiliations

  1. Department of Gastroenterology and Hepatology, Chinese PLA General Hospital, Haidian District, No. 28 of Fuxing Road, Beijing, 100853, China

    Chen Du, Ningli Chai, Enqiang Linghu, Huikai Li, Xiuxue Feng, Xiangdong Wang & Ping Tang

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  1. Chen Du
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Correspondence to Enqiang Linghu.

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Drs. Chen Du, Ningli Chai, Enqiang Linghu, Huikai Li, Xiuxue Feng, Jing Yang, Xiangdong Wang and Ping Tang have no conflicts of interest or financial ties to disclose.

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Du, C., Chai, N., Linghu, E. et al. Diagnostic value of SpyGlass for pancreatic cystic lesions: comparison of EUS-guided fine-needle aspiration and EUS-guided fine-needle aspiration combined with SpyGlass. Surg Endosc 36, 904–910 (2022). https://doi.org/10.1007/s00464-021-08347-8

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