Endoscopy 2019; 51(04): S222
DOI: 10.1055/s-0039-1681834
ESGE Days 2019 ePosters
Friday, April 5, 2019 09:00 – 17:00: Endoscopic ultrasound ePosters
Georg Thieme Verlag KG Stuttgart · New York

RAPID ON-SITE EVALUATION (ROSE) FOR EUS-GUIDED FINE NEEDLE ASPIRATION (EUS-FNA) OF SOLID PANCREATIC LESIONS: “ON SITE” MULTIDISCIPLINARY TEAM IS THE PIVOT FOR AN ACCURATE DIAGNOSIS

N Olivari
1   Medicine Gastroenterology and Endoscopy, Fondazione Poliambulanza, Brescia, Italy
,
SM Milluzzo
1   Medicine Gastroenterology and Endoscopy, Fondazione Poliambulanza, Brescia, Italy
2   Department of Gastroenterology and Digestive Endoscopy, Catholic University, Rome, Italy
,
M Graffeo
1   Medicine Gastroenterology and Endoscopy, Fondazione Poliambulanza, Brescia, Italy
2   Department of Gastroenterology and Digestive Endoscopy, Catholic University, Rome, Italy
,
M Lovera
1   Medicine Gastroenterology and Endoscopy, Fondazione Poliambulanza, Brescia, Italy
,
D Bianchi
3   Pathology Unit, Fondazione Poliambulanza, Brescia, Italy
,
E Padolecchia
3   Pathology Unit, Fondazione Poliambulanza, Brescia, Italy
,
C Spada
1   Medicine Gastroenterology and Endoscopy, Fondazione Poliambulanza, Brescia, Italy
4   EETC European Endoscopy Training Centre, Catholic University, Rome, Italy
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

Also available at
 

Aims:

Compare the adequacy, diagnostic yield and accuracy of EUS-FNA for solid pancreatic lesions before and after introduction of ROSE in a single center study.

Methods:

All consecutive EUS-FNA procedures for pancreatic lesions performed during the first year of adoption (ROSE1 group) and the following year (ROSE2 group) were compared to those performed during the previous year (pre-ROSE group). EUS-FNA was performed using a linear echoendoscope using 22 or 25 Gauge diameter needles. Adequacy (sample provides sufficient material for evaluation), diagnostic yield (established diagnosis rate), diagnostic accuracy (correspondence between cases for which a diagnosis was rendered and the gold standard) of EUS-FNA were evaluated. Specimen were categorized into: diagnostic in presence of a specific diagnosis and non diagnostic if no sufficient cells or atypias were reported. Histological analysis of surgical specimen, when available, was considered the gold standard for diagnosis; otherwise, clinical and radiologic follow-up compatible with neoplasia (positive) or absence of deterioration/spontaneous resolution (negative) were examined.

Results:

94 pancreatic lesions in 92 patients were enrolled (26, 30 and 38 in pre-ROSE, ROSE1 and ROSE2 groups, respectively). Patient number and age, lesion size and localization, technique (needle diameter, number of passages) were omogeneous. Adequacy rate was 96.2%, 93.3% and 100% in pre-ROSE, ROSE1 and ROSE2 groups, respectively (p = NS); diagnostic yield was 76.9%, 86.7%, 92.1% and accuracy 65.4%, 76.7% and 86.8% respectively, with significant difference between pre-ROSE and ROSE2 groups (p < 0.5).

Conclusions:

The use of ROSE during EUS-FNA for solid pancreatic lesions is associated with an improvement in terms of diagnostic yield and accuracy, but it does not seem to improve the adequacy of FNA. Rather than the technique adopted, the multidisciplinary team is the real pivot for an accurate diagnosis.