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Use of suction during endoscopic ultrasound-guided fine needle biopsy of solid pancreatic lesions with a Franseen-tip needle: a pilot comparative trial

Background and study aims  The utility of suction during endoscopic ultrasound (EUS) fine-needle biopsy (FNB) using Franseen-tip needle remains unclear and has not been evaluated in randomized trials. We designed a randomized crossover trial to compare the diagnostic yield during EUS-FNB using a 22G...

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Autores principales: Costa-Moreira, Pedro, Vilas-Boas, Filipe, Martins, Diana, Moutinho-Ribeiro, Pedro, Lopes, Susana, Lopes, Joanne, Barroca, Helena, Macedo, Guilherme
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Georg Thieme Verlag KG 2021
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7895663/
https://www.ncbi.nlm.nih.gov/pubmed/33655040
http://dx.doi.org/10.1055/a-1336-3170
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author Costa-Moreira, Pedro
Vilas-Boas, Filipe
Martins, Diana
Moutinho-Ribeiro, Pedro
Lopes, Susana
Lopes, Joanne
Barroca, Helena
Macedo, Guilherme
author_facet Costa-Moreira, Pedro
Vilas-Boas, Filipe
Martins, Diana
Moutinho-Ribeiro, Pedro
Lopes, Susana
Lopes, Joanne
Barroca, Helena
Macedo, Guilherme
author_sort Costa-Moreira, Pedro
collection PubMed
description Background and study aims  The utility of suction during endoscopic ultrasound (EUS) fine-needle biopsy (FNB) using Franseen-tip needle remains unclear and has not been evaluated in randomized trials. We designed a randomized crossover trial to compare the diagnostic yield during EUS-FNB using a 22G Franseen-tip needle, with and without standard suction. Patients and methods  Consecutive patients undergoing EUS-guided sampling of solid pancreatic lesions were recruited. A minimum of two passes were performed for each case: one with 20-mL syringe suction (S+) and another without (S–). The order of passes was randomized and the pathologist blinded. The endpoints were the diagnostic yield and the impact of blood contamination in the diagnosis. Results  Fifty consecutive patients were enrolled. The overall diagnostic accuracy was 84 %. A diagnosis of malignancy was obtained in 70 samples: 36 in the S+group and 34 in the S–group. A statistically significant difference was seen in the diagnostic accuracy (S+: 78 % vs. S–: 72 %, P  < 0.01) and blood contamination (S+: 68 %; S–: 44 %, P  < 0.01). The sensitivity, specificity, negative likelihood ratio and positive likelihood ratio for S+vs. S–samples were 76.6 % vs. 73.9 %, 100 % vs. 100 % and 0.23 vs. 0.26, NA vs NA, respectively. A negative impact of blood contamination in the overall diagnostic yield wasn’t seen, even in samples where suction was used (OR 0.36, P  = 0.15) Conclusions  We found a higher diagnostic yield with the use of suction. It was associated with a higher degree of sample blood contamination that did not affect the diagnostic performance.
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spelling pubmed-78956632021-03-01 Use of suction during endoscopic ultrasound-guided fine needle biopsy of solid pancreatic lesions with a Franseen-tip needle: a pilot comparative trial Costa-Moreira, Pedro Vilas-Boas, Filipe Martins, Diana Moutinho-Ribeiro, Pedro Lopes, Susana Lopes, Joanne Barroca, Helena Macedo, Guilherme Endosc Int Open Background and study aims  The utility of suction during endoscopic ultrasound (EUS) fine-needle biopsy (FNB) using Franseen-tip needle remains unclear and has not been evaluated in randomized trials. We designed a randomized crossover trial to compare the diagnostic yield during EUS-FNB using a 22G Franseen-tip needle, with and without standard suction. Patients and methods  Consecutive patients undergoing EUS-guided sampling of solid pancreatic lesions were recruited. A minimum of two passes were performed for each case: one with 20-mL syringe suction (S+) and another without (S–). The order of passes was randomized and the pathologist blinded. The endpoints were the diagnostic yield and the impact of blood contamination in the diagnosis. Results  Fifty consecutive patients were enrolled. The overall diagnostic accuracy was 84 %. A diagnosis of malignancy was obtained in 70 samples: 36 in the S+group and 34 in the S–group. A statistically significant difference was seen in the diagnostic accuracy (S+: 78 % vs. S–: 72 %, P  < 0.01) and blood contamination (S+: 68 %; S–: 44 %, P  < 0.01). The sensitivity, specificity, negative likelihood ratio and positive likelihood ratio for S+vs. S–samples were 76.6 % vs. 73.9 %, 100 % vs. 100 % and 0.23 vs. 0.26, NA vs NA, respectively. A negative impact of blood contamination in the overall diagnostic yield wasn’t seen, even in samples where suction was used (OR 0.36, P  = 0.15) Conclusions  We found a higher diagnostic yield with the use of suction. It was associated with a higher degree of sample blood contamination that did not affect the diagnostic performance. Georg Thieme Verlag KG 2021-03 2021-02-19 /pmc/articles/PMC7895663/ /pubmed/33655040 http://dx.doi.org/10.1055/a-1336-3170 Text en The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/) https://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License, which permits unrestricted reproduction and distribution, for non-commercial purposes only; and use and reproduction, but not distribution, of adapted material for non-commercial purposes only, provided the original work is properly cited.
spellingShingle Costa-Moreira, Pedro
Vilas-Boas, Filipe
Martins, Diana
Moutinho-Ribeiro, Pedro
Lopes, Susana
Lopes, Joanne
Barroca, Helena
Macedo, Guilherme
Use of suction during endoscopic ultrasound-guided fine needle biopsy of solid pancreatic lesions with a Franseen-tip needle: a pilot comparative trial
title Use of suction during endoscopic ultrasound-guided fine needle biopsy of solid pancreatic lesions with a Franseen-tip needle: a pilot comparative trial
title_full Use of suction during endoscopic ultrasound-guided fine needle biopsy of solid pancreatic lesions with a Franseen-tip needle: a pilot comparative trial
title_fullStr Use of suction during endoscopic ultrasound-guided fine needle biopsy of solid pancreatic lesions with a Franseen-tip needle: a pilot comparative trial
title_full_unstemmed Use of suction during endoscopic ultrasound-guided fine needle biopsy of solid pancreatic lesions with a Franseen-tip needle: a pilot comparative trial
title_short Use of suction during endoscopic ultrasound-guided fine needle biopsy of solid pancreatic lesions with a Franseen-tip needle: a pilot comparative trial
title_sort use of suction during endoscopic ultrasound-guided fine needle biopsy of solid pancreatic lesions with a franseen-tip needle: a pilot comparative trial
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7895663/
https://www.ncbi.nlm.nih.gov/pubmed/33655040
http://dx.doi.org/10.1055/a-1336-3170
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