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Feasibility and yield of a novel 22-gauge histology EUS needle in patients with pancreatic masses: a multicenter prospective cohort study

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Abstract

Background

The option of obtaining tissue samples for histological examination during endoscopic ultrasound (EUS) has theoretical and practical advantages over cytology alone. The aim of this study was to evaluate the feasibility, yield, and diagnostic accuracy of a new EUS 22-G fine-needle biopsy (FNB) device in patients with solid pancreatic masses in a multicenter, prospective study.

Methods

All consecutive patients who underwent EUS-guided fine-needle biopsy (EUS-FNB) using a newly developed 22-G FNB needle between September 2010 and October 2010 were enrolled in the study. The EUS-FNB technique was standardized among the participating endoscopists. Only a single needle pass was performed.

Results

A total of 61 patients (35 males, mean age 64.2 ± 12.4 years) with solid pancreatic masses with a mean size of 32.4 ± 8.5 mm (range 13–90 mm) participated. EUS-FNB was performed through the duodenum in 35 cases (57.4 %) and was technically feasible in all but one of the 61 (98.4 %) patients without complications. Tissue samples for histological examination were obtained from 55 patients (90.2 %) and were deemed adequate in 54 of the cases (88.5 %). The diagnoses established by EUS-FNB were adenocarcinoma (39 patients), neuroendocrine tumors (5), chronic focal pancreatitis (5), sarcoma (2), lymphoma (1), acinar cellular tumor (1), and pancreatic metastasis from renal cell carcinoma (1). In an intention-to-treat (ITT) analysis, sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for the histologic diagnosis of a pancreatic mass were 87.5, 100, 100, 41.7, and 88.5 %, respectively.

Conclusions

EUS-FNB was technically feasible in 98 % of patients with a solid pancreatic mass. A suitable sample for histological evaluation was obtained in 88.5 % of the cases after only one single needle pass. The apparently low negative predictive value is likely to be improved by increasing the number of needle passes.

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Acknowledgments

Cook Medical supported this trial with products.

Disclosures

Drs. Alberto Larghi, Julio Iglesias-Garcia, Jan-Werner Poley, Geneviève Monges, Maria Chiara Petrone, Guido Rindi, Ihab Abdulkader, Paolo Giorgio Arcidiacono, Guido Costamagna, Katharina Biermann, Erwan Bories, Claudio Doglioni, J. Enrique Dominguez-Muñoz, Cesare Hassan, Marco Bruno, and Marc Giovannini, have no conflicts of interest or financial ties to disclose.

Author information

Authors and Affiliations

  1. Digestive Endoscopy Unit, Catholic University, Largo A. Gemelli 8, 00168, Rome, Italy

    Alberto Larghi, Guido Costamagna & Cesare Hassan

  2. Gastroenterology Department, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain

    Julio Iglesias-Garcia & J. Enrique Dominguez-Muñoz

  3. Foundation for Research in Digestive Diseases (FIENAD), University Hospital of Santiago de Compostela, Santiago de Compostela, Spain

    Julio Iglesias-Garcia & J. Enrique Dominguez-Muñoz

  4. Department of Gastroenterology and Hepatology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands

    Jan-Werner Poley & Marco Bruno

  5. Gastroenterology and Gastrointestinal Endoscopy Unit, Vita Salute San Raffaele University, Milan, Italy

    Maria Chiara Petrone & Paolo Giorgio Arcidiacono

  6. Endoscopic Unit, Paoli-Calmettes Institute, Marseilles, France

    Erwan Bories & Marc Giovannini

  7. Pathology Department, Paoli-Calmettes Institute, Marseilles, France

    Geneviève Monges

  8. Pathology Department, Catholic University, Rome, Italy

    Guido Rindi

  9. Pathology Department, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain

    Ihab Abdulkader

  10. Pathology Department, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands

    Katharina Biermann

  11. Pathology Department, Vita Salute San Raffaele University, Milan, Italy

    Claudio Doglioni

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  1. Alberto Larghi
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  15. Marco Bruno
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Correspondence to Alberto Larghi.

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Larghi, A., Iglesias-Garcia, J., Poley, JW. et al. Feasibility and yield of a novel 22-gauge histology EUS needle in patients with pancreatic masses: a multicenter prospective cohort study. Surg Endosc 27, 3733–3738 (2013). https://doi.org/10.1007/s00464-013-2957-9

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