Endoscopic ultrasound core needle for diagnosing of solid pancreatic lesions: is rapid on-site evaluation really necessary?

Abstract:

INTRODUCTION:Endoscopic ultrasound (EUS) guided fine needle aspiration (FNA) has a crucial role in the diagnosis of solid pancreatic lesions and rapid on-site evaluation (ROSE) can increase its diagnostic yield. Rapid on-site evaluation is not always available and after EUS-FNA provides a cytology specimen with scant cellularity. Fine needle biopsy (FNB) specimens containing core tissue may theoretically overcome the limitations of EUS-FNA sampling. It could be hypothesized that EUS-FNB without ROSE could achieve the same adequacy and accuracy of EUS-FNB with ROSE. The aim of this review is to evaluate the evidence on the role of ROSE in the setting of EUS-guided tissue acquisition with core needles in patients with solid pancreatic lesions. EVIDENCE ACQUISITION:All relevant articles were extracted up to February 2017 based on the results of searches in PubMed, Scopus and Google Scholar. EVIDENCE SYNTHESIS:A total of 21 pertinent articles were finally included. Among the included studies, 11 were performed without ROSE, 8 with ROSE, and 2 were performed both with and without ROSE. In the ROSE group we found a sensitivity, specificity, overall diagnostic adequacy and overall diagnostic accuracy of 96%, 100%, 86.5%, 85.5%, respectively, while in the no-ROSE group 86.6%, 100%, 89.5%, 86.1% were found, respectively. Mild pancreatitis (mean rates, 3.43%) and abdominal pain (mean rates, 3.6%) were reported as most frequent adverse events. CONCLUSIONS:Endoscopic ultrasound guided-FNB without ROSE offers similar results in terms of adequacy and accuracy as in the presence of an on-site cytopathologist.

journal_name

Minerva Med

journal_title

Minerva medica

authors

Arena M,Eusebi LH,Pellicano R,Palamara MA,Iabichino G,Consolo P,Fagoonee S,Opocher E,Barabino M,Luigiano C

doi

10.23736/S0026-4806.17.05327-7

subject

Has Abstract

pub_date

2017-12-01 00:00:00

pages

547-553

issue

6

eissn

0026-4806

issn

1827-1669

pii

S0026-4806.17.05327-7

journal_volume

108

pub_type

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