Retrospective analysis of the utility of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) in pancreatic masses, using a 22-gauge or 25-gauge needle system: A multicenter experience

T. E. Yusuf, Sammy Ho, D. A. Pavey, H. Michael, G. Gress F. G. Gress

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Abstract

Background and study aims: Endoscopic ultrasound- guided fine-needle aspiration (EUS-FNA) is nowperformed routinely in many advanced endoscopy centers and has enhanced the ability to diagnose pancreatic masses. However, there is uncertainty about which needle size is optimal for EUS-FNA of pancreatic masses. We aimed to evaluate the performance of the 22-gauge and 25-gauge needles in obtaining cytologic diagnosis of pancreatic masses. Methods: All cases that were referred for EUSFNA for pancreatic masses between February 2001 and June 2007 were reviewed, and patients who underwent EUS-FNA using the 22-gauge and 25-gauge needle system were identified. In patients who underwent surgery, operative histopathological findings were compared with the cytopathological findings from EUS-FNA. Results: A total of 842 patients with pancreatic masses detected on computed tomography (CT) and/or magnetic resonance imaging (MRI) and confirmed by EUS underwent EUS-FNA with the 22-gauge needle (n = 540) or the 25-gauge needle (n = 302). Results of EUS-FNA cytology findings were compared with the gold standard of surgical histopathological findings or long-term clinical follow-up. The sensitivity, specificity, PPV, and NPV of FNA were respectively 84%, 100%, 100%, and 49% for the 22-gauge needle compared with 92%, 97%, 98%, and 89%, respectively for the 25-gauge needle. No complications were noted in the 25-gauge needle group, compared with pancreatitis in 2% of the 22-gauge needle group. Conclusions: This retrospective comparative study shows that EUS-FNA with a 25-gauge needle system is a safe and reliable method for tissue sampling in pancreatic masses. The system is more sensitive and has a higher NPV than the standard 22-gauge needle. Our study suggests that perhaps the smaller caliber FNA needle causes less trauma during EUS-FNA and hence less complications. Further studies including randomized trials are needed.

Original languageEnglish (US)
Pages (from-to)445-448
Number of pages4
JournalEndoscopy
Volume41
Issue number5
DOIs
StatePublished - 2009

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Endoscopic Ultrasound-Guided Fine Needle Aspiration
Needles
Pancreatitis
Endoscopy
Uncertainty
Cell Biology

ASJC Scopus subject areas

  • Gastroenterology

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Retrospective analysis of the utility of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) in pancreatic masses, using a 22-gauge or 25-gauge needle system : A multicenter experience. / Yusuf, T. E.; Ho, Sammy; Pavey, D. A.; Michael, H.; F. G. Gress, G. Gress.

In: Endoscopy, Vol. 41, No. 5, 2009, p. 445-448.

Research output: Contribution to journalArticle

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abstract = "Background and study aims: Endoscopic ultrasound- guided fine-needle aspiration (EUS-FNA) is nowperformed routinely in many advanced endoscopy centers and has enhanced the ability to diagnose pancreatic masses. However, there is uncertainty about which needle size is optimal for EUS-FNA of pancreatic masses. We aimed to evaluate the performance of the 22-gauge and 25-gauge needles in obtaining cytologic diagnosis of pancreatic masses. Methods: All cases that were referred for EUSFNA for pancreatic masses between February 2001 and June 2007 were reviewed, and patients who underwent EUS-FNA using the 22-gauge and 25-gauge needle system were identified. In patients who underwent surgery, operative histopathological findings were compared with the cytopathological findings from EUS-FNA. Results: A total of 842 patients with pancreatic masses detected on computed tomography (CT) and/or magnetic resonance imaging (MRI) and confirmed by EUS underwent EUS-FNA with the 22-gauge needle (n = 540) or the 25-gauge needle (n = 302). Results of EUS-FNA cytology findings were compared with the gold standard of surgical histopathological findings or long-term clinical follow-up. The sensitivity, specificity, PPV, and NPV of FNA were respectively 84{\%}, 100{\%}, 100{\%}, and 49{\%} for the 22-gauge needle compared with 92{\%}, 97{\%}, 98{\%}, and 89{\%}, respectively for the 25-gauge needle. No complications were noted in the 25-gauge needle group, compared with pancreatitis in 2{\%} of the 22-gauge needle group. Conclusions: This retrospective comparative study shows that EUS-FNA with a 25-gauge needle system is a safe and reliable method for tissue sampling in pancreatic masses. The system is more sensitive and has a higher NPV than the standard 22-gauge needle. Our study suggests that perhaps the smaller caliber FNA needle causes less trauma during EUS-FNA and hence less complications. Further studies including randomized trials are needed.",
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