Forward-viewing echoendoscope versus standard echoendoscope for endoscopic ultrasound-guided tissue acquisition of solid lesions: a randomized, multicenter study

Alberto Larghi; Mostafa Ibrahim; Lorenzo Fuccio; Selma Lekkerkerker; Pierre Eisendrath; Leonardo Frazzoni; Paul Fockens; Marina La Marca; Jeanin E. van Hooft; Jacques Deviere; Guido Costamagna

doi:10.1055/a-0790-8342

Endoscopy, Table of Contents

Endoscopy 2019; 51(05): 444-451
DOI: 10.1055/a-0790-8342

Original article

Forward-viewing echoendoscope versus standard echoendoscope for endoscopic ultrasound-guided tissue acquisition of solid lesions: a randomized, multicenter study

Authors

Alberto Larghi

¹Digestive Endoscopy Unit, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy
Mostafa Ibrahim

²Department of Gastroenterology, Hepatopancreatology, and Digestive Oncology, Erasme University Hospital – Université Libre de Bruxelles, Brussels, Belgium
Lorenzo Fuccio

³Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
Selma Lekkerkerker

⁴Department of Gastroenterology and Hepatology Academic Medical Center University of Amsterdam, Amsterdam, The Netherlands
Pierre Eisendrath

²Department of Gastroenterology, Hepatopancreatology, and Digestive Oncology, Erasme University Hospital – Université Libre de Bruxelles, Brussels, Belgium
Leonardo Frazzoni

³Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
Paul Fockens

⁴Department of Gastroenterology and Hepatology Academic Medical Center University of Amsterdam, Amsterdam, The Netherlands
Marina La Marca

³Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
Jeanin E. van Hooft

⁴Department of Gastroenterology and Hepatology Academic Medical Center University of Amsterdam, Amsterdam, The Netherlands
Jacques Deviere

²Department of Gastroenterology, Hepatopancreatology, and Digestive Oncology, Erasme University Hospital – Université Libre de Bruxelles, Brussels, Belgium
Guido Costamagna

¹Digestive Endoscopy Unit, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy

⁵Digestive Endoscopy Unit, Fondazione Policlinico Universitario Agostino Gemelli, Università Cattolica del Sacro Cuore, IRCCS, Rome, Italy

⁶IHU-USIAS, University of Strasbourg, Strasbourg, France

Abstract

Background A forward-viewing linear (FVL) echoendoscope has been developed with the aim of overcoming some of the limitations of standard curved linear-array (CLA) echoendoscopes. There are no existing studies comparing the performance of the two echoendoscopes for endoscopic ultrasound-guided tissue acquisition (EUS-TA) of solid lesions other than subepithelial lesions.

Methods This was a prospective, multicenter, randomized trial with a noninferiority design comparing FVL vs. CLA echoendoscopes in patients with solid lesions of the gastrointestinal tract or adjacent organs. Primary outcomes were successful identification of the lesion and success of EUS-TA. Secondary outcomes were safety, sensitivity, specificity, and diagnostic accuracy of the two different scopes for EUS-TA.

Results 126 patients with solid lesions were randomly assigned to the CLA group (63 patients) or the FVL group (63 patients). The two groups were homogeneous with no differences in terms of needle type used, mean number of passes, and site of EUS-TA. No differences were observed between the FVL vs. CLA scopes in identification of the lesion (96.8 % vs. 98.4 %; P > 0.99) and technical success of EUS-TA (92.1 % vs. 96.8 %; P = 0.44). No adverse events occurred. Overall, diagnostic accuracy (77.8 % vs. 84.1 %), sensitivity (76.6 % vs. 84.1 %), and specificity (81.3 % vs. 84.2 %) did not differ between the two groups.

Conclusions Our results strongly suggest that the FVL echoendoscope is noninferior to the CLA scope for the detection and performance of EUS-TA in patients with solid lesions of the gastrointestinal tract and adjacent organs. In addition, the FVL scope has the same diagnostic yield, accuracy, and safety as the CLA scope.

Full Text

References

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