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Endosonographer’s macroscopic evaluation of EUS-FNAB specimens after interactive cytopathologic training: a single-center prospective validation cohort study

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Abstract

Background

In many centers, rapid on-site evaluation (ROSE) for the specimens obtained from endoscopic ultrasound-guided fine-needle aspiration biopsy (EUS-FNAB) is not available. The aim of this study was to compare the diagnostic yields of EUS-FNAB in the presence or absence of ROSE.

Methods

Seventy-five patients who underwent EUS-FNAB for the pancreatic, gastric subepithelial, and mesenteric mass lesions at our institution from November 2013 to August 2014 were included. For 20 patients in the pilot cohort, EUS-FNAB was performed with ROSE, and simultaneously, training of the staff endosonographer for tissue adequacy by an on-site cytopathologist was also performed.

Results

The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of EUS-FNAB in the pilot cohort were 91.7, 100.0, 100.0, 88.9, and 95.0 %, respectively. The 3.2 ± 0.8 [mean ± standard deviation (SD)] needle passes were needed in this cohort. Fifty-five patients were enrolled as a validation cohort from April 2014 to August 2014, and tissue adequacies were assessed by an experienced endosonographer without ROSE in this cohort. The sensitivity, specificity, PPV, NPV, and accuracy of EUS-FNAB in this validation cohort were 92.1, 100.0, 100.0, 85.0, and 94.6 %, respectively. The 4.5 ± 0.6 (mean ± SD) needle passes were needed in this cohort (p < 0.01 compared to pilot cohort).

Conclusions

Diagnostic accuracy of EUS-FNAB in which the adequacy of sample was assessed by an attending endosonographer was acceptable. This study suggests that on-site evaluation by a trained endosonographer may be an alternative tool to ROSE where ROSE is not available.

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Abbreviations

EUS-FNAB:

Endoscopic ultrasound-guided fine-needle aspiration and biopsy

GIST:

Gastrointestinal stromal tumor

IPMN:

Intraductal papillary mucinous neoplasm

NPV:

Negative predictive value

NS:

Not significant

PPV:

Positive predictive value

ROSE:

Rapid on-site evaluation

SD:

Standard deviation

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Authors and Affiliations

  1. Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 108, Pyung-Dong, Jongro-Ku, Seoul, 110-746, Korea

    Hong Joo Kim, Yoon Suk Jung, Jung Ho Park, Dong Il Park, Yong Kyun Cho, Chong Il Sohn, Woo Kyu Jeon, Byung Ik Kim & Kyu Yong Choi

  2. Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea

    Seungho Ryu

Authors
  1. Hong Joo Kim
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  2. Yoon Suk Jung
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  3. Jung Ho Park
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  4. Dong Il Park
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  10. Seungho Ryu
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Corresponding author

Correspondence to Hong Joo Kim.

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Disclosures

This study was financially supported by a grant from Myungmoon Pharmaceuticals (Seoul, Korea).

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Kim, H.J., Jung, Y.S., Park, J.H. et al. Endosonographer’s macroscopic evaluation of EUS-FNAB specimens after interactive cytopathologic training: a single-center prospective validation cohort study. Surg Endosc 30, 4184–4192 (2016). https://doi.org/10.1007/s00464-015-4727-3

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  • DOI: https://doi.org/10.1007/s00464-015-4727-3

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