scholarly journals S998 Endoscopic Ultrasound (EUS) Guided Fine-Needle Biopsy (FNB) Has Higher Diagnostic Yield but Similar Accuracy Than EUS Fine Needle Aspirate (FNA) for Pancreatic Neuroendocrine Tumor Grading: A Meta-Analysis

2021 ◽  
Vol 116 (1) ◽  
pp. S476-S476
Author(s):  
Manik Aggarwal ◽  
Prabhat Kumar ◽  
Rajat Garg ◽  
Dheera Grover ◽  
Amandeep Singh ◽  
...  
Keyword(s):  
Neuroendocrine Tumor ◽  
Needle Biopsy ◽  
Diagnostic Yield ◽  
Meta Analysis ◽  
Pancreatic Neuroendocrine Tumor ◽  
Fine Needle Biopsy ◽  
Fine Needle Aspirate ◽  
Tumor Grading ◽  
Fine Needle ◽  
Similar Accuracy

scholarly journals A meta-analysis of endoscopic ultrasound–fine-needle aspiration compared to endoscopic ultrasound–fine-needle biopsy: diagnostic yield and the value of onsite cytopathological assessment

2017 ◽  
Vol 05 (05) ◽  
pp. E363-E375 ◽  
Author(s):  
Muhammad Khan ◽  
Ian Grimm ◽  
Bilal Ali ◽  
Richard Nollan ◽  
Claudio Tombazzi ◽  
...  
Keyword(s):  
Endoscopic Ultrasound ◽  
Needle Biopsy ◽  
Diagnostic Yield ◽  
Meta Analysis ◽  
Fine Needle Biopsy ◽  
Needle Aspiration ◽  
Fine Needle ◽  
Significant Difference ◽  
Meta Regression ◽  
Optimal Quality

Abstract Background The diagnostic yield of endoscopic ultrasound (EUS) guided fine-needle aspiration (FNA) is variable, and partly dependent upon rapid onsite evaluation (ROSE) by a cytopathologist. Second generation fine-needle biopsy (FNB) needles are being increasingly used to obtain core histological tissue samples. Aims Studies comparing the diagnostic yield of EUS guided FNA versus FNB have reached conflicting conclusions. We therefore conducted a systematic review and meta-analysis to compare the diagnostic yield of FNA with FNB, and specifically evaluating the diagnostic value of ROSE while comparing the two types of needles. Methods We searched several databases from inception to 10 April 2016 to identify studies comparing diagnostic yield of second generation FNB needles with standard FNA needles. Risk ratios (RR) were calculated for categorical outcomes of interest (diagnostic adequacy, diagnostic accuracy, and optimal quality histological cores obtained). Standard mean difference (SMD) was calculated for continuous variables (number of passes required for diagnosis). These were pooled using random effects model of meta-analysis to account for heterogeneity. Meta-regression was conducted to evaluate the effect of ROSE on various outcomes of interest. Results Fifteen studies with a total of 1024 patients were included in the analysis. We found no significant difference in diagnostic adequacy [RR 0.98 (0.91, 1.06), (I 2 = 51 %)]. Although not statistically significant (P = 0.06), by meta-regression, in the absence of ROSE, FNB showed a relatively better diagnostic adequacy. For solid pancreatic lesions only, there was no difference in diagnostic adequacy [RR 0.96 (0.86, 1.09), (I 2 = 66 %)]. By meta-regression, in the absence of ROSE, FNB was associated with better diagnostic adequacy (P = 0.02). There was no difference in diagnostic accuracy [RR 0.99 (0.95, 1.03), (I 2 = 27 %)] or optimal quality core histological sample procurement [RR 0.97 (0.89, 1.05), (I 2 = 9.6 %)]. However, FNB established diagnosis with fewer passes [SMD 0.93 (0.45, 1.42), (I 2 = 84 %)]. The absence of ROSE was associated with a higher SMD, i. e., in the presence of an onsite pathologist, FNA required relatively fewer passes to establish the diagnosis than in the absence of an onsite pathologist. Conclusions There is no significant difference in the diagnostic yield between FNA and FNB, when FNA is accompanied by ROSE. However, in the absence of ROSE, FNB is associated with a relatively better diagnostic adequacy in solid pancreatic lesions. Also, FNB requires fewer passes to establish the diagnosis.

scholarly journals Ultrasound-Guided Fine-Needle Biopsy of First 1000 Consecutive Thyroid Nodules: Single-Surgeon Experience

OTO Open ◽  
2020 ◽  
Vol 4 (2) ◽  
pp. 2473974X2092900
Author(s):  
Jagdish K. Dhingra
Keyword(s):  
Learning Curve ◽  
Needle Biopsy ◽  
Thyroid Nodules ◽  
Diagnostic Yield ◽  
Statistical Significance ◽  
Fine Needle Biopsy ◽  
Ultrasound Guided ◽  
Fine Needle ◽  
Surgeon Experience ◽  
Chi Square Analysis

Objective To study the feasibility, safety, and learning curve of ultrasound-guided fine-needle biopsy (USGFNB) performed by a newly trained otolaryngologist in a community office in a setting. Study Design Collect USGFNB data of all thyroid nodules in a prospective manner. Setting A dedicated ultrasound clinic in a large community-based practice, operated by a single surgeon with the purpose of providing office-based point-of-care diagnostic ultrasonography and USGFNB. Subjects and Methods Data on the first 1000 unselected consecutive thyroid nodules that underwent USGFNB over a 3-year period were analyzed. Chi-square analysis was used to assess the statistical significance of characteristics of diagnostic vs nondiagnostic nodules. A multivariate regression analysis was conducted to determine nodule characteristics predictive of adequate sampling. Diagnostic yield and time efficiency data were plotted over a 3-year period to study the learning curve for the USGFNB procedure performed by an operator with no previous experience. Results A total of 1000 nodules in 734 patients including 142 males and 592 females (age range, 17-87 years) were studied. Of the patients, 188 of 734 had more than 1 nodule biopsied, with a maximum of 4 nodules biopsied in 1 setting. The procedure was successfully completed in all patients, with no major complications. A steep learning curve was observed, and adequate samples were obtained in 91.9% of the patients on the first attempt. The cystic nature of the nodule was the biggest predictor of a nondiagnostic yield. Conclusions Otolaryngologist-performed USGFNB of the thyroid is safe, effective, and desirable.

scholarly journals Yield of biliary stent cytology: Is it time to think lean?

2019 ◽  
Vol 07 (04) ◽  
pp. E545-E550 ◽  
Author(s):  
Muthuraman Alagappan ◽  
Natasha Darras ◽  
Lauren Yang ◽  
Paul Vanderlaan ◽  
Meir Mizrahi ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Needle Biopsy ◽  
Diagnostic Yield ◽  
Medical Center ◽  
Academic Medical Center ◽  
Tertiary Care ◽  
Fine Needle Biopsy ◽  
Biliary Stent ◽  
Fine Needle ◽  
Cytologic Analysis

Abstract Background and study aims During evaluation of pancreaticobiliary strictures, it is common practice to send biliary stents for cytologic analysis. However, in recent years, complementary tissue acquisition techniques ranging from cholangioscopy to fine-needle biopsy have improved the ability to acquire tissue and diagnose malignancy. Data are limited on the current diagnostic yield and cost effectiveness of biliary stent analysis. Patients and methods We performed a retrospective study of all pancreaticobiliary stents sent for analysis in a tertiary care academic medical center from June 2013 to September 2016. Patient demographics, stent information, and final diagnosis history were collected through chart review. Costs were determined using published reimbursement rates for Medicare. Results Two hundred thirty-one stents from 175 patients were sent for cytologic analysis during the study period. Of the 62 stents obtained from patients ultimately diagnosed with malignancy, only one (1.6 %) had positive cytology for malignant cells, while the others were acellular/non-diagnostic (2/62, 3.2 %), negative (48/62, 77.4 %), or atypical (11/62, 17.7 %). The sensitivity of stent cytology for diagnosis of malignancy was 1.6 % (1/62). No cases were identified in which stent cytology changed clinical management. From a payer perspective, the mean estimated cost for each stent cytologic analysis is greater than $ 70.00. Conclusions While stent cytologic analysis is a common clinical practice, the diagnostic yield and cost effectiveness of the practice must be reevaluated. With the rise of newer diagnostic technologies such as digital cholangioscopy and endoscopic ultrasound-guided fine-needle biopsy, it may be time to “think lean” and acknowledge a sunset for biliary stent cytology.

Prospective comparative study of endoscopic ultrasonography-guided fine-needle biopsy and unroofing biopsy.

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 38-38 ◽  
Author(s):  
Sung Kwan Shin ◽  
Jun Chul Park ◽  
Eun Hye Kim ◽  
Sang Kil Lee ◽  
Yong Chan Lee
Keyword(s):  
Comparative Study ◽  
Endoscopic Ultrasonography ◽  
Needle Biopsy ◽  
Diagnostic Yield ◽  
Fine Needle Biopsy ◽  
Histological Diagnosis ◽  
Fine Needle ◽  
Significant Difference ◽  
Prospective Comparative Study ◽  
The Mean

38 Background: Adequate tissue acquisition is important in making treatment decisions for patients with upper gastrointestinal subepithelial tumors (SETs). This study aimed to compare the outcomes of endoscopic ultrasonography-guided fine-needle biopsy (EUS-FNB) with those of the unroofing biopsy technique. Methods: This study was a single-center, prospective comparative study conducted at Severance Hospital, Yonsei University College of Medicine. A total of 39 patients with SETs ≥15 mm were enrolled between January 2016 and August 2017. Results: Of the 39 patients, 28 underwent biopsy with both techniques (4 underwent only unroofing and 7 underwent only EUS-FNB). The mean tumor size was 21.0 mm (median, 19.0 mm; 15.0–45.0 mm). Histological diagnosis was made with EUS-FNB in 64.3% and with unroofing biopsy in 78.6% (p = 0.344), and immunohistochemical diagnosis was made with EUS-FNB in 46.4% and unroofing biopsy in 67.9% (p = 0.180). In the subgroup analysis (28 patients), there was no significant difference in diagnostic yield between the 2 methods. The mean procedural time with EUS-FNB was shorter than that with unroofing biopsy (p < 0.001). The larger SET (≥ 20 mm) (p = 0.035) and satisfaction of procedure (p = 0.019) were positively associated with successful histological diagnosis by EUS-FNB. No complications were reported with both methods. Conclusions: There was no significant difference in the histological diagnostic yield for SETs between the EUS-FNB and unroofing biopsy techniques. Further study is needed to confirm the efficacy of EUS-FNB and unroofing biopsy in a larger study population. Clinical trial information: NCT02646241.

Efficacy of endoscopic ultrasonography-guided fine needle aspiration for pancreatic neuroendocrine tumor grading

Pancreatology ◽  
2016 ◽  
Vol 16 (4) ◽  
pp. S139
Author(s):  
Mitsuru Sugimoto ◽  
Tadayuki Takagi ◽  
Rei Suzuki ◽  
Naoki Konno ◽  
Ko Watanabe ◽  
...  
Keyword(s):  
Neuroendocrine Tumor ◽  
Endoscopic Ultrasonography ◽  
Fine Needle Aspiration ◽  
Pancreatic Neuroendocrine Tumor ◽  
Needle Aspiration ◽  
Tumor Grading ◽  
Fine Needle

scholarly journals Improved diagnostic yield of endoscopic ultrasound-fine needle biopsy with histology specimen processing

2020 ◽  
Vol 12 (8) ◽  
pp. 212-219
Author(s):  
Lawrence Ku ◽  
Mohammad A Shahshahan ◽  
Linda A Hou ◽  
Viktor E Eysselein ◽  
Sofiya Reicher
Keyword(s):  
Endoscopic Ultrasound ◽  
Needle Biopsy ◽  
Diagnostic Yield ◽  
Fine Needle Biopsy ◽  
Fine Needle ◽  
Specimen Processing
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