scholarly journals Complications of Endoscopic Ultrasound-Guided Fine Needle Aspiration: A Narrative Review

Diagnostics ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. 964
Author(s):  
Masafumi Mizuide ◽  
Shomei Ryozawa ◽  
Akashi Fujita ◽  
Tomoya Ogawa ◽  
Hiromune Katsuda ◽  
...  
Keyword(s):  
Endoscopic Ultrasound ◽  
Fine Needle Aspiration ◽  
Diagnostic Performance ◽  
Needle Aspiration ◽  
Comprehensive Understanding ◽  
Ultrasound Guided ◽  
Fine Needle ◽  
Gastrointestinal Lesions ◽  
Life Threatening ◽  
Low Rate

Considerable progress has been made recently in the use of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) to diagnose intra-luminal gastrointestinal lesions and extra-luminal lesions near the gastrointestinal tract. Numerous reports have indicated that EUS-FNA has high diagnostic performance and safety, which has led to the routine use of EUS-FNA and an increasing number of cases. Thus, while EUS-FNA has a low rate of complications, endoscopists may encounter these complications as the number of cases increases. Infrequent reports have also described life-threatening complications. Therefore, endoscopists should possess a comprehensive understanding of the complications of EUS-FNA, which include hemorrhage, perforation, infection, and acute pancreatitis, as well as their management. This review examines the available evidence regarding the complications associated with EUS-FNA, and the findings will be useful for ensuring that endoscopists perform EUS-FNA safely and appropriately.

scholarly journals A Comparison of Endoscopic Ultrasound-Guided Fine-Needle Aspiration and Fine-Needle Biopsy in the Diagnosis of Solid Pancreatic Lesions

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Lachlan R. Ayres ◽  
Elizabeth K. Kmiotek ◽  
Eric Lam ◽  
Jennifer J. Telford
Keyword(s):  
Diagnostic Accuracy ◽  
Endoscopic Ultrasound ◽  
Fine Needle Aspiration ◽  
Needle Biopsy ◽  
Diagnostic Performance ◽  
Fine Needle Biopsy ◽  
Needle Aspiration ◽  
True Positive ◽  
Ultrasound Guided ◽  
Fine Needle

Background and Aims. Endoscopic ultrasound (EUS) guided fine-needle aspiration (FNA) is the method of choice for sampling pancreatic lesions. This study compares the diagnostic accuracy and safety of FNB using a novel core needle to FNA in solid pancreatic lesions. Methods. A retrospective review of patients in whom EUS FNA or FNB was performed for solid pancreatic lesions was conducted. Diagnostic performance was calculated based upon a dual classification system: classification 1, only malignant pathology considered a true positive, versus classification 2, atypical, suspicious, and malignant pathology considered a true positive. Results. 43 patients underwent FNB compared with 51 FNA. Using classification 1, sensitivity was 74.0% versus 80.0%, specificity 100% versus 100%, and diagnostic accuracy 77.0% versus 80.0% for FNB versus FNA, respectively (all p>0.05). Using classification 2, sensitivity was 97% versus 94.0%, specificity 100% versus 100%, and diagnostic accuracy 98.0% versus 94.0% for FNB versus FNA, respectively (all p>0.05). FNB required significantly fewer needle passes (median = 2) compared to FNA (median = 3; p<0.001). Adverse events occurred in two (4.5%) FNB patients compared with none in the FNA group (p>0.05). Conclusion. FNA and FNB have comparable sensitivity and diagnostic accuracy. FNB required fewer passes.

scholarly journals Comparison of 22G standard and Franseen needles in endoscopic ultrasound-guided fine-needle aspiration for diagnosing pancreatic mass lesions: Study protocol for a controlled trial

Trials ◽  
2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Masahiro Itonaga ◽  
Satoru Yasukawa ◽  
Toshio Shimokawa ◽  
Mamoru Takenaka ◽  
Nobuyasu Fukutake ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Endoscopic Ultrasound ◽  
Fine Needle Aspiration ◽  
Diagnostic Performance ◽  
Controlled Trial ◽  
Needle Aspiration ◽  
Pancreatic Mass ◽  
Ultrasound Guided ◽  
Fine Needle ◽  
Mass Lesions

Abstract Background Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) was developed with the aim of further improving the diagnostic performance of endoscopic ultrasound. Although novel puncture needles have been specifically designed for collecting sufficient tissue specimens, clinical studies have indicated no clear difference in diagnostic performance between these novel needles and conventional puncture needles. Recently, a needle with Franseen geometry was developed specifically for EUS-FNA biopsy. Due to the characteristic shape of its tip, the Franseen needle is expected to be effective for scraping tissues, thus potentially increasing the diagnostic accuracy of EUS-FNA biopsy. We plan to carry out a prospective, multicenter, open-labeled, controlled trial to compare conventional and Franseen needles in terms of the diagnostic accuracy of EUS-FNA for evaluating the malignancy of pancreatic mass lesions. Methods/design The study will enroll 520 patients with pancreatic mass managed at any of 21 participating endoscopic centers. Lesion samples obtained using 22G conventional and Franseen needles will be assessed to compare the efficacy and safety of these two types of needles in EUS-FNA for evaluating the malignancy of mass lesions in the pancreas. Tissue samples will be fixed in formalin and processed for histologic evaluation. For the purpose of this study, only samples obtained with the first needle pass will be used for comparing the: (i) accuracy of the malignancy diagnosis, (ii) sensitivity and specificity for the malignancy diagnosis, (iii) procedure completion rate, (iv) sample cellularity, and (v) incidence of complications. Patient enrollment begins on July 17, 2018. Discussion The outcomes of this study may provide insight into the optimal needle choice for evaluating the malignancy of pancreatic solid lesions, thus aiding in the development of practice guidelines for pancreatic diseases. Trial registration University Hospital Medical Information Network Clinical Trials Registry (UMIN-CTR), UMIN000030634. Registered on 29 December 2017. http://www.umin.ac.jp/ Version number: 01.2017.12.28.

scholarly journals Comparison of 22G Standard and Franseen Needles in Endoscopic Ultrasound-Guided Fine-Needle Aspiration for Diagnosing Pancreatic Mass Lesions: Study Protocol for a Controlled Trial

2019 ◽  
Author(s):  
Masahiro Itonaga ◽  
Satoru Yasukawa ◽  
Toshio Shimokawa ◽  
Mamoru Takenaka ◽  
Nobuyasu Fukutake ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Endoscopic Ultrasound ◽  
Fine Needle Aspiration ◽  
Diagnostic Performance ◽  
Controlled Trial ◽  
Needle Aspiration ◽  
Pancreatic Mass ◽  
Ultrasound Guided ◽  
Fine Needle ◽  
Mass Lesions

Abstract Background Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) was developed with the aim of further improving the diagnostic performance of endoscopic ultrasound. Although novel puncture needles have been specifically designed for collecting sufficient tissue specimens, clinical studies have indicated no clear difference in diagnostic performance between these novel needles and conventional puncture needles. Recently, a needle with Franseen geometry was developed specifically for EUS-FNA biopsy. Due to the characteristic shape of its tip, the Franseen needle is expected to be effective for scraping tissues, thus potentially increasing the diagnostic accuracy of EUS-FNA biopsy. We plan to carry out a prospective, multicenter, open-labeled, controlled trial to compare conventional and Franseen needles in terms of the diagnostic accuracy of EUS-FNA for evaluating the malignancy of pancreatic mass lesions. Methods/design The study will enroll 520 patients with pancreatic mass managed at any of 21 participating endoscopic centers. Lesion samples obtained using 22G conventional and Franseen needles will be assessed to compare the efficacy and safety of these two types of needles in EUS-FNA for evaluating the malignancy of mass lesions in the pancreas. Tissue samples will be fixed in formalin and processed for histologic evaluation. For the purpose of this study, only samples obtained with the first needle pass will be used for comparing the: (i) accuracy of the malignancy diagnosis, (ii) sensitivity and specificity for the malignancy diagnosis, (iii) procedure completion rate, (iv) sample cellularity, and (v) incidence of complications. Discussion The outcomes of this study may provide insight into the optimal needle choice for evaluating the malignancy of pancreatic solid lesions, thus aiding in the development of practice guidelines for pancreatic diseases.

The Diagnostic Accuracy of Endoscopic Ultrasound-Guided Fine Needle Aspiration in Patients with Endoscopic Biopsy Negative Upper Gastrointestinal Lesions

2021 ◽  
Vol 17 (2) ◽  
pp. 188-193
Author(s):  
Muhammad Najm ul Hasan Shafi ◽  
Irfan Ali ◽  
Muhammad Ismail ◽  
Hassam Zulfiqar ◽  
Izatullah ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Endoscopic Ultrasound ◽  
Fine Needle Aspiration ◽  
Needle Aspiration ◽  
Ultrasound Guided ◽  
Fine Needle ◽  
Upper Gi ◽  
Endoscopic Biopsies ◽  
Gastrointestinal Lesions

Objective To determine the diagnostic accuracy of endoscopic ultrasound guided (EUS) fine needle aspiration in patients who had inconclusive endoscopic biopsies of the same lesion Methodology This retrospective study was conducted at Pak Emirates Military Hospital, Rawalpindi, Pakistan from Jan 2018 to July 2020. Patients who underwent EUS guided FNAC from June 2017 to July 2020 were screened. The FNAC results of patients satisfying the inclusion ciritera were compared with either a surgical biopsy in patients in whom surgeries were done, while in the remaining patients, EUS FNAC results were compared with a 3 months radiological and/or 6 months clinical follow-up. The final diagnosis was defined based on the following criteria: (1) Malignant lesions (n=36), histopathologic diagnosis obtained based on surgery resected samples (n=18) or clinical diagnosis as neoplasm based on clinical follow-up of symptoms (n=30) or radiologic diagnosis based on imaging follow-up at 3 months (n=13) (2) Benign lesions (n=18), benign cytopathologic histopathologic findings and clinical follow-up with no evidence of malignant progression or metastasis. Results EUS-guided FNA cytology turned out to be malignant in 60 percent (n=36) of the specimens. 30 percent of the samples showed benign epithelial cytology ( n=18) while in 10 percent  of the cases (n=6), the tissue samples were deemed insufficient for cytological diagnosis. The accuracy came out to be 66.6 percent (n=10 were true negative), sensitivity 93.4 percent, and specificity 100 percent.  Conclusion EUS guided-FNA cytology of the sub-mucosal upper GI lesions is highly sensitive and specific for upper GI lesions, which are negative on endoscopic biopsies.

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