Comparison of Endoscopic Ultrasound-Fine-needle Aspiration and Endoscopic Ultrasound-Fine-needle Biopsy for Solid Lesions in a Multicenter, Randomized Trial

Satish Nagula, Kamron Pourmand, Harry Aslanian, Juan Carlos Bucobo, Tamas A. Gonda, Susana Gonzalez, Adam Goodman, Seth A. Gross, Sammy Ho, Christopher J. DiMaio, Michelle K. Kim, Shireen Pais, John M. Poneros, David H. Robbins, Felice Schnoll-Sussman, Amrita Sethi, Jonathan M. Buscaglia

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background & Aims: Endoscopic ultrasound with fine-needle aspiration (FNA) is the standard of care for tissue sampling of solid lesions adjacent to the gastrointestinal tract. Fine-needle biopsy (FNB) may provide higher diagnostic yield with fewer needle passes. The aim of this study was to assess the difference in diagnostic yield between FNA and FNB. Methods: This is a multicenter, prospective randomized clinical trial from 6 large tertiary care centers. Patients referred for tissue sampling of solid lesions were randomized to either FNA or FNB of the target lesion. Demographics, size, location, number of needle passes, and final diagnosis were recorded. Results: After enrollment, 135 patients were randomized to FNA (49.3%), and 139 patients were randomized to FNB (50.7%).The following lesions were sampled: mass (n = 210, 76.6%), lymph nodes (n = 46, 16.8%), and submucosal tumors (n = 18, 6.6%). Final diagnosis was malignancy (n = 192, 70.1%), reactive lymphadenopathy (n = 30, 11.0%), and spindle cell tumors (n = 24, 8.8%). FNA had a diagnostic yield of 91.1% compared with 88.5% for FNB (P = .48). There was no difference between FNA and FNB when stratified by the presence of on-site cytopathology or by type of lesion sampled. A median of 1 needle pass was needed to obtain a diagnostic sample for both needles. Conclusions: FNA and FNB obtained a similar diagnostic yield with a comparable number of needle passes. On the basis of these results, there is no significant difference in the performance of FNA compared with FNB in the cytologic diagnosis of solid lesions adjacent to the gastrointestinal tract. ClinicalTrials.gov identifier: NCT01698190.

Original languageEnglish (US)
JournalClinical Gastroenterology and Hepatology
DOIs
StateAccepted/In press - 2017

Fingerprint

Fine Needle Biopsy
Multicenter Studies
Needles
Gastrointestinal Tract
Neoplasms
Standard of Care
Tertiary Care Centers

Keywords

  • Endoscopic Ultrasound
  • Fine Needle Aspiration
  • Fine Needle Biopsy
  • New York Endoscopic Research Outcomes Group
  • NYERO

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

Cite this

Comparison of Endoscopic Ultrasound-Fine-needle Aspiration and Endoscopic Ultrasound-Fine-needle Biopsy for Solid Lesions in a Multicenter, Randomized Trial. / Nagula, Satish; Pourmand, Kamron; Aslanian, Harry; Bucobo, Juan Carlos; Gonda, Tamas A.; Gonzalez, Susana; Goodman, Adam; Gross, Seth A.; Ho, Sammy; DiMaio, Christopher J.; Kim, Michelle K.; Pais, Shireen; Poneros, John M.; Robbins, David H.; Schnoll-Sussman, Felice; Sethi, Amrita; Buscaglia, Jonathan M.

In: Clinical Gastroenterology and Hepatology, 2017.

Research output: Contribution to journalArticle

Nagula, S, Pourmand, K, Aslanian, H, Bucobo, JC, Gonda, TA, Gonzalez, S, Goodman, A, Gross, SA, Ho, S, DiMaio, CJ, Kim, MK, Pais, S, Poneros, JM, Robbins, DH, Schnoll-Sussman, F, Sethi, A & Buscaglia, JM 2017, 'Comparison of Endoscopic Ultrasound-Fine-needle Aspiration and Endoscopic Ultrasound-Fine-needle Biopsy for Solid Lesions in a Multicenter, Randomized Trial', Clinical Gastroenterology and Hepatology. https://doi.org/10.1016/j.cgh.2017.06.013
Nagula, Satish ; Pourmand, Kamron ; Aslanian, Harry ; Bucobo, Juan Carlos ; Gonda, Tamas A. ; Gonzalez, Susana ; Goodman, Adam ; Gross, Seth A. ; Ho, Sammy ; DiMaio, Christopher J. ; Kim, Michelle K. ; Pais, Shireen ; Poneros, John M. ; Robbins, David H. ; Schnoll-Sussman, Felice ; Sethi, Amrita ; Buscaglia, Jonathan M. / Comparison of Endoscopic Ultrasound-Fine-needle Aspiration and Endoscopic Ultrasound-Fine-needle Biopsy for Solid Lesions in a Multicenter, Randomized Trial. In: Clinical Gastroenterology and Hepatology. 2017.
@article{2b3c8c998611487196ec3d2e2ca115fe,
title = "Comparison of Endoscopic Ultrasound-Fine-needle Aspiration and Endoscopic Ultrasound-Fine-needle Biopsy for Solid Lesions in a Multicenter, Randomized Trial",
abstract = "Background & Aims: Endoscopic ultrasound with fine-needle aspiration (FNA) is the standard of care for tissue sampling of solid lesions adjacent to the gastrointestinal tract. Fine-needle biopsy (FNB) may provide higher diagnostic yield with fewer needle passes. The aim of this study was to assess the difference in diagnostic yield between FNA and FNB. Methods: This is a multicenter, prospective randomized clinical trial from 6 large tertiary care centers. Patients referred for tissue sampling of solid lesions were randomized to either FNA or FNB of the target lesion. Demographics, size, location, number of needle passes, and final diagnosis were recorded. Results: After enrollment, 135 patients were randomized to FNA (49.3{\%}), and 139 patients were randomized to FNB (50.7{\%}).The following lesions were sampled: mass (n = 210, 76.6{\%}), lymph nodes (n = 46, 16.8{\%}), and submucosal tumors (n = 18, 6.6{\%}). Final diagnosis was malignancy (n = 192, 70.1{\%}), reactive lymphadenopathy (n = 30, 11.0{\%}), and spindle cell tumors (n = 24, 8.8{\%}). FNA had a diagnostic yield of 91.1{\%} compared with 88.5{\%} for FNB (P = .48). There was no difference between FNA and FNB when stratified by the presence of on-site cytopathology or by type of lesion sampled. A median of 1 needle pass was needed to obtain a diagnostic sample for both needles. Conclusions: FNA and FNB obtained a similar diagnostic yield with a comparable number of needle passes. On the basis of these results, there is no significant difference in the performance of FNA compared with FNB in the cytologic diagnosis of solid lesions adjacent to the gastrointestinal tract. ClinicalTrials.gov identifier: NCT01698190.",
keywords = "Endoscopic Ultrasound, Fine Needle Aspiration, Fine Needle Biopsy, New York Endoscopic Research Outcomes Group, NYERO",
author = "Satish Nagula and Kamron Pourmand and Harry Aslanian and Bucobo, {Juan Carlos} and Gonda, {Tamas A.} and Susana Gonzalez and Adam Goodman and Gross, {Seth A.} and Sammy Ho and DiMaio, {Christopher J.} and Kim, {Michelle K.} and Shireen Pais and Poneros, {John M.} and Robbins, {David H.} and Felice Schnoll-Sussman and Amrita Sethi and Buscaglia, {Jonathan M.}",
year = "2017",
doi = "10.1016/j.cgh.2017.06.013",
language = "English (US)",
journal = "Clinical Gastroenterology and Hepatology",
issn = "1542-3565",
publisher = "W.B. Saunders Ltd",

}

TY - JOUR

T1 - Comparison of Endoscopic Ultrasound-Fine-needle Aspiration and Endoscopic Ultrasound-Fine-needle Biopsy for Solid Lesions in a Multicenter, Randomized Trial

AU - Nagula, Satish

AU - Pourmand, Kamron

AU - Aslanian, Harry

AU - Bucobo, Juan Carlos

AU - Gonda, Tamas A.

AU - Gonzalez, Susana

AU - Goodman, Adam

AU - Gross, Seth A.

AU - Ho, Sammy

AU - DiMaio, Christopher J.

AU - Kim, Michelle K.

AU - Pais, Shireen

AU - Poneros, John M.

AU - Robbins, David H.

AU - Schnoll-Sussman, Felice

AU - Sethi, Amrita

AU - Buscaglia, Jonathan M.

PY - 2017

Y1 - 2017

N2 - Background & Aims: Endoscopic ultrasound with fine-needle aspiration (FNA) is the standard of care for tissue sampling of solid lesions adjacent to the gastrointestinal tract. Fine-needle biopsy (FNB) may provide higher diagnostic yield with fewer needle passes. The aim of this study was to assess the difference in diagnostic yield between FNA and FNB. Methods: This is a multicenter, prospective randomized clinical trial from 6 large tertiary care centers. Patients referred for tissue sampling of solid lesions were randomized to either FNA or FNB of the target lesion. Demographics, size, location, number of needle passes, and final diagnosis were recorded. Results: After enrollment, 135 patients were randomized to FNA (49.3%), and 139 patients were randomized to FNB (50.7%).The following lesions were sampled: mass (n = 210, 76.6%), lymph nodes (n = 46, 16.8%), and submucosal tumors (n = 18, 6.6%). Final diagnosis was malignancy (n = 192, 70.1%), reactive lymphadenopathy (n = 30, 11.0%), and spindle cell tumors (n = 24, 8.8%). FNA had a diagnostic yield of 91.1% compared with 88.5% for FNB (P = .48). There was no difference between FNA and FNB when stratified by the presence of on-site cytopathology or by type of lesion sampled. A median of 1 needle pass was needed to obtain a diagnostic sample for both needles. Conclusions: FNA and FNB obtained a similar diagnostic yield with a comparable number of needle passes. On the basis of these results, there is no significant difference in the performance of FNA compared with FNB in the cytologic diagnosis of solid lesions adjacent to the gastrointestinal tract. ClinicalTrials.gov identifier: NCT01698190.

AB - Background & Aims: Endoscopic ultrasound with fine-needle aspiration (FNA) is the standard of care for tissue sampling of solid lesions adjacent to the gastrointestinal tract. Fine-needle biopsy (FNB) may provide higher diagnostic yield with fewer needle passes. The aim of this study was to assess the difference in diagnostic yield between FNA and FNB. Methods: This is a multicenter, prospective randomized clinical trial from 6 large tertiary care centers. Patients referred for tissue sampling of solid lesions were randomized to either FNA or FNB of the target lesion. Demographics, size, location, number of needle passes, and final diagnosis were recorded. Results: After enrollment, 135 patients were randomized to FNA (49.3%), and 139 patients were randomized to FNB (50.7%).The following lesions were sampled: mass (n = 210, 76.6%), lymph nodes (n = 46, 16.8%), and submucosal tumors (n = 18, 6.6%). Final diagnosis was malignancy (n = 192, 70.1%), reactive lymphadenopathy (n = 30, 11.0%), and spindle cell tumors (n = 24, 8.8%). FNA had a diagnostic yield of 91.1% compared with 88.5% for FNB (P = .48). There was no difference between FNA and FNB when stratified by the presence of on-site cytopathology or by type of lesion sampled. A median of 1 needle pass was needed to obtain a diagnostic sample for both needles. Conclusions: FNA and FNB obtained a similar diagnostic yield with a comparable number of needle passes. On the basis of these results, there is no significant difference in the performance of FNA compared with FNB in the cytologic diagnosis of solid lesions adjacent to the gastrointestinal tract. ClinicalTrials.gov identifier: NCT01698190.

KW - Endoscopic Ultrasound

KW - Fine Needle Aspiration

KW - Fine Needle Biopsy

KW - New York Endoscopic Research Outcomes Group

KW - NYERO

UR - http://www.scopus.com/inward/record.url?scp=85030645296&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85030645296&partnerID=8YFLogxK

U2 - 10.1016/j.cgh.2017.06.013

DO - 10.1016/j.cgh.2017.06.013

M3 - Article

C2 - 28624647

AN - SCOPUS:85030645296

JO - Clinical Gastroenterology and Hepatology

JF - Clinical Gastroenterology and Hepatology

SN - 1542-3565

ER -