Feasibility and Accuracy of Transduodenal Endoscopic Ultrasound-Guided Fine-Needle Aspiration of Solid Lesions Using a 19-Gauge Flexible Needle: A Multicenter Study.

Endoscopic ultrasound-guided fine-needle aspiration Endosonography Feasibility studies

Journal

Clinical endoscopy
ISSN: 2234-2400
Titre abrégé: Clin Endosc
Pays: Korea (South)
ID NLM: 101576886

Informations de publication

Date de publication:
Mar 2021
Historique:
received: 24 02 2020
accepted: 01 04 2020
pubmed: 25 5 2020
medline: 25 5 2020
entrez: 25 5 2020
Statut: ppublish

Résumé

Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is the go-to method for obtaining samples from gastrointestinal tract and pancreatic lesions. When the transduodenal approach is utilized, the use of a more flexible needle, such as a nitinol 19-gauge (G) needle, has been recommended. The aim of this study was to evaluate the feasibility and accuracy of 19-G flexible aspiration needles in obtaining samples from solid lesions through a transduodenal approach. This was a retrospective analysis of prospectively collected data from eight Italian endoscopy centers. Consecutive patients with solid lesions who underwent transduodenal EUS-FNA with a 19-G flexible needle were included. A total of 201 patients were enrolled. According to histology, EUS, radiology and 12 months of follow-up, 151 patients had malignant lesions and 50 patients had benign lesions. EUS-FNA was feasible in all cases. An adequate histologic sample was obtained in all except eight cases (96.1%). The sensitivity of EUS-FNA was 92.1% (95% confidence interval [CI], 86.8%-95.7%), and the specificity was 100% (95% CI, 90.5%-100%). The positive predictive value was 100% (95% CI, 93.4%-100%), and the negative predictive value was 74% (95% CI, 62.8%-82.7%). The diagnostic accuracy was 93.5% (95% CI, 89.2%-96.5%). The transduodenal approach for obtaining samples from solid lesions using a 19-G flexible needle seems feasible and accurate.

Sections du résumé

BACKGROUND/AIMS OBJECTIVE
Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is the go-to method for obtaining samples from gastrointestinal tract and pancreatic lesions. When the transduodenal approach is utilized, the use of a more flexible needle, such as a nitinol 19-gauge (G) needle, has been recommended. The aim of this study was to evaluate the feasibility and accuracy of 19-G flexible aspiration needles in obtaining samples from solid lesions through a transduodenal approach.
METHODS METHODS
This was a retrospective analysis of prospectively collected data from eight Italian endoscopy centers. Consecutive patients with solid lesions who underwent transduodenal EUS-FNA with a 19-G flexible needle were included.
RESULTS RESULTS
A total of 201 patients were enrolled. According to histology, EUS, radiology and 12 months of follow-up, 151 patients had malignant lesions and 50 patients had benign lesions. EUS-FNA was feasible in all cases. An adequate histologic sample was obtained in all except eight cases (96.1%). The sensitivity of EUS-FNA was 92.1% (95% confidence interval [CI], 86.8%-95.7%), and the specificity was 100% (95% CI, 90.5%-100%). The positive predictive value was 100% (95% CI, 93.4%-100%), and the negative predictive value was 74% (95% CI, 62.8%-82.7%). The diagnostic accuracy was 93.5% (95% CI, 89.2%-96.5%).
CONCLUSION CONCLUSIONS
The transduodenal approach for obtaining samples from solid lesions using a 19-G flexible needle seems feasible and accurate.

Identifiants

pubmed: 32447874
pii: ce.2020.056
doi: 10.5946/ce.2020.056
pmc: PMC8039733
doi:

Types de publication

Journal Article

Langues

eng

Pagination

229-235

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Auteurs

Germana de Nucci (G)

Gastroenterology and Endoscopy Unit, ASST Rhodense, Garbagnate Milanese, Milan, Italy.

Maria Chiara Petrone (MC)

Bilio Pancreatic Endoscopy and Endoscopy Ultrasound Unit, San Raffaele Hospital, Milan, Italy.

Nicola Imperatore (N)

Gastroenterology Unit, Federico II University, Naples, Italy.
Gastroenterology and Endoscopy Unit, AORN Antonio Cardarelli, Naples, Italy.

Edoardo Forti (E)

Endoscopy Unit, Ca Grande Niguarda Hospital, Milan, Italy.

Roberto Grassia (R)

Endoscopy Unit, Cremona Hospital, Cremona, Italy.

Silvia Giovanelli (S)

Gastroenterology and Endoscopy Unit, Forlì-Cesena Hospital, Forlì, Italy.

Laura Ottaviani (L)

Gastroenterology Unit, Santa Maria Hospital, Perugia, Italy.

Vincenzo Mirante (V)

Endoscopy Unit, Carpi Civil Hospital, Carpi, Italy.

Giuseppe Sabatino (G)

Gastroenterology Unit, Cosenza Civil Hospital, Cosenza, Italy.

Carlo Fabbri (C)

Gastroenterology and Endoscopy Unit, Forlì-Cesena Hospital, Forlì, Italy.

Mauro Manno (M)

Endoscopy Unit, Carpi Civil Hospital, Carpi, Italy.

Paolo Giorgio Arcidiacono (PG)

Bilio Pancreatic Endoscopy and Endoscopy Ultrasound Unit, San Raffaele Hospital, Milan, Italy.

Gianpiero Manes (G)

Gastroenterology and Endoscopy Unit, ASST Rhodense, Garbagnate Milanese, Milan, Italy.

Classifications MeSH