EUS-guided fine needle aspiration with and without trucut biopsy of pancreatic masses

Syed Mubashir Shah, Afonso Ribeiro, Joe Levi, Merce Jorda, Caio Rocha-Lima, Danny Sleeman, Kara Hamilton-Nelson, Parvin Ganjei-Azar, Jamie S Barkin

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

Context: Endoscopic ultrasound-guided trucut biopsy (EUS TCB) has a lower yield than fine needle aspiration (FNA) in pancreatic masses but the additional use of TCB to FNA may improve the diagnostic accuracy over FNA alone. Objective: To compare the yield of EUS FNA alone or combined with EUS TCB for diagnosis of pancreatic masses. Design: Single center retrospective case control study conducted at academic tertiary center. Study conducted between March 2004 and April 2007. Participants: A total of 126 consecutive patients referred for EUS guided biopsy of pancreatic mass; three patients excluded from analysis, final cohort comprised 123 patients (108 malignant and 15 benign). EUS FNA was performed in 72 patients and EUS FNA+TCB was performed in 51 patients. Main outcome measures: The diagnostic performance of EUS FNA versus EUS FNA+TCB was compared. Results: The, sensitivity, specificity and frequency of cases correctly identified for malignancy of FNA alone were 87.1% (54/62), 100% (10/10) and 88.8% (64/72), while for the combination of FNA+TCB they were: 95.7% (44/46), 100% (5/5) and 96.0% (49/51), respectively (P=0.184, 1.000, and 0.193 FNA versus FNA+TCB). No major complication occurred in either group. Conclusion: FNA+TCB can be safely performed in selected lesions but sensitivity is not statistically improved over FNA alone (95.7% versus 87.1%).

Original languageEnglish
Pages (from-to)422-430
Number of pages9
JournalJournal of the Pancreas
Volume9
Issue number4
StatePublished - Aug 13 2008

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Fine Needle Biopsy
Biopsy
Case-Control Studies
Cohort Studies
Outcome Assessment (Health Care)

Keywords

  • Biopsy
  • Biopsy, fine-needle
  • Cytological techniques
  • Endosonography
  • Pancreatic diseases
  • Pancreatic neoplasms

ASJC Scopus subject areas

  • Endocrinology
  • Gastroenterology

Cite this

EUS-guided fine needle aspiration with and without trucut biopsy of pancreatic masses. / Shah, Syed Mubashir; Ribeiro, Afonso; Levi, Joe; Jorda, Merce; Rocha-Lima, Caio; Sleeman, Danny; Hamilton-Nelson, Kara; Ganjei-Azar, Parvin; Barkin, Jamie S.

In: Journal of the Pancreas, Vol. 9, No. 4, 13.08.2008, p. 422-430.

Research output: Contribution to journalArticle

Shah, SM, Ribeiro, A, Levi, J, Jorda, M, Rocha-Lima, C, Sleeman, D, Hamilton-Nelson, K, Ganjei-Azar, P & Barkin, JS 2008, 'EUS-guided fine needle aspiration with and without trucut biopsy of pancreatic masses', Journal of the Pancreas, vol. 9, no. 4, pp. 422-430.
Shah, Syed Mubashir ; Ribeiro, Afonso ; Levi, Joe ; Jorda, Merce ; Rocha-Lima, Caio ; Sleeman, Danny ; Hamilton-Nelson, Kara ; Ganjei-Azar, Parvin ; Barkin, Jamie S. / EUS-guided fine needle aspiration with and without trucut biopsy of pancreatic masses. In: Journal of the Pancreas. 2008 ; Vol. 9, No. 4. pp. 422-430.
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abstract = "Context: Endoscopic ultrasound-guided trucut biopsy (EUS TCB) has a lower yield than fine needle aspiration (FNA) in pancreatic masses but the additional use of TCB to FNA may improve the diagnostic accuracy over FNA alone. Objective: To compare the yield of EUS FNA alone or combined with EUS TCB for diagnosis of pancreatic masses. Design: Single center retrospective case control study conducted at academic tertiary center. Study conducted between March 2004 and April 2007. Participants: A total of 126 consecutive patients referred for EUS guided biopsy of pancreatic mass; three patients excluded from analysis, final cohort comprised 123 patients (108 malignant and 15 benign). EUS FNA was performed in 72 patients and EUS FNA+TCB was performed in 51 patients. Main outcome measures: The diagnostic performance of EUS FNA versus EUS FNA+TCB was compared. Results: The, sensitivity, specificity and frequency of cases correctly identified for malignancy of FNA alone were 87.1{\%} (54/62), 100{\%} (10/10) and 88.8{\%} (64/72), while for the combination of FNA+TCB they were: 95.7{\%} (44/46), 100{\%} (5/5) and 96.0{\%} (49/51), respectively (P=0.184, 1.000, and 0.193 FNA versus FNA+TCB). No major complication occurred in either group. Conclusion: FNA+TCB can be safely performed in selected lesions but sensitivity is not statistically improved over FNA alone (95.7{\%} versus 87.1{\%}).",
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AU - Shah, Syed Mubashir

AU - Ribeiro, Afonso

AU - Levi, Joe

AU - Jorda, Merce

AU - Rocha-Lima, Caio

AU - Sleeman, Danny

AU - Hamilton-Nelson, Kara

AU - Ganjei-Azar, Parvin

AU - Barkin, Jamie S

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N2 - Context: Endoscopic ultrasound-guided trucut biopsy (EUS TCB) has a lower yield than fine needle aspiration (FNA) in pancreatic masses but the additional use of TCB to FNA may improve the diagnostic accuracy over FNA alone. Objective: To compare the yield of EUS FNA alone or combined with EUS TCB for diagnosis of pancreatic masses. Design: Single center retrospective case control study conducted at academic tertiary center. Study conducted between March 2004 and April 2007. Participants: A total of 126 consecutive patients referred for EUS guided biopsy of pancreatic mass; three patients excluded from analysis, final cohort comprised 123 patients (108 malignant and 15 benign). EUS FNA was performed in 72 patients and EUS FNA+TCB was performed in 51 patients. Main outcome measures: The diagnostic performance of EUS FNA versus EUS FNA+TCB was compared. Results: The, sensitivity, specificity and frequency of cases correctly identified for malignancy of FNA alone were 87.1% (54/62), 100% (10/10) and 88.8% (64/72), while for the combination of FNA+TCB they were: 95.7% (44/46), 100% (5/5) and 96.0% (49/51), respectively (P=0.184, 1.000, and 0.193 FNA versus FNA+TCB). No major complication occurred in either group. Conclusion: FNA+TCB can be safely performed in selected lesions but sensitivity is not statistically improved over FNA alone (95.7% versus 87.1%).

AB - Context: Endoscopic ultrasound-guided trucut biopsy (EUS TCB) has a lower yield than fine needle aspiration (FNA) in pancreatic masses but the additional use of TCB to FNA may improve the diagnostic accuracy over FNA alone. Objective: To compare the yield of EUS FNA alone or combined with EUS TCB for diagnosis of pancreatic masses. Design: Single center retrospective case control study conducted at academic tertiary center. Study conducted between March 2004 and April 2007. Participants: A total of 126 consecutive patients referred for EUS guided biopsy of pancreatic mass; three patients excluded from analysis, final cohort comprised 123 patients (108 malignant and 15 benign). EUS FNA was performed in 72 patients and EUS FNA+TCB was performed in 51 patients. Main outcome measures: The diagnostic performance of EUS FNA versus EUS FNA+TCB was compared. Results: The, sensitivity, specificity and frequency of cases correctly identified for malignancy of FNA alone were 87.1% (54/62), 100% (10/10) and 88.8% (64/72), while for the combination of FNA+TCB they were: 95.7% (44/46), 100% (5/5) and 96.0% (49/51), respectively (P=0.184, 1.000, and 0.193 FNA versus FNA+TCB). No major complication occurred in either group. Conclusion: FNA+TCB can be safely performed in selected lesions but sensitivity is not statistically improved over FNA alone (95.7% versus 87.1%).

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