Abstract
Background and aims This study aimed to evaluate the performance of Macroscopic On-site Evaluation (MOSE)
using a novel endoscopic ultrasound (EUS) fine needle biopsy (FNB) needle (22-G Franseen-tip
needle, Acquire, Boston Scientific Incorporated, Boston, Massachusetts, United States),
and without using Rapid On-Site Evaluation (ROSE).
Method Between May 2016 and August 2016, all consecutive patients referred to our center
for EUS tissue acquisition (TA) for solid lesions underwent EUS-FNB with the 22-G
Franseen-tip needle unless contra-indicated. The operator performed MOSE. If no macroscopic
core was visualized, a second pass was performed. The final diagnosis was defined
as unequivocal histology from EUS-TA with compatible 18 months follow-up, surgical
resection, or both. We retrospectively analyzed the performance of MOSE.
Results A total of 46 consecutive patients was included, and 54 solid lesions were biopsied.
The endosonographer visualized core tissue in 93 % (50/54) of targets with a single
pass, of which the pathologist confirmed histologic core fragments in 94 % (47/50).
Four lesions required two passes, and the overall correlation between MOSE and histologic
core fragments was 94 % (48/51). Diagnostic adequacy was 98 % (53/54) with one biliary
target biopsied without significant material. The overall diagnostic accuracy was
94 %. Sensitivity, specificity, positive predictive value, and negative predictive
value for malignancy were 92 %, 100 %, 100 %, and 81 %, respectively. No adverse events
were reported.
Conclusion Our study demonstrated that MOSE using the 22-G Franseen-tip needle could limit needle
passes by accurately estimating histologic core fragments. It also demonstrated that
high diagnostic adequacy and accuracy of > 90 % could be achieved without ROSE.
