Endoscopy 2020; 52(S 01): S310-S311
DOI: 10.1055/s-0040-1704997
ESGE Days 2020 ePoster presentations
Thursday, April 23, 2020 09:00 – 17:00 Endoscopic ultrasound ePoster area
© Georg Thieme Verlag KG Stuttgart · New York

COMPARISON BETWEEN ACCURACY OF FLEXIBLE NITINOL FINE NEEDLE ASPIRATION(FNA) AND FINE NEEDLE BIOPSY(FNB) ENDOSCOPIC ULTRASOUND (EUS) NEEDLES FOR SOLID PANCREATIC MASSES-RETROSPECTIVE BICENTRIC ANALYSIS

S Bota
1   Klinikum Klagenfurt am Wörthersee, Department of Internal Medicine and Gastroenterology (IMuG), Hepatology, Endocrinology, Rheumatology and Nephrology and Emergency Medicine (ZAE) with Centralized Endoscopy Service, Klagenfurt, Austria
,
M Razpotnik
1   Klinikum Klagenfurt am Wörthersee, Department of Internal Medicine and Gastroenterology (IMuG), Hepatology, Endocrinology, Rheumatology and Nephrology and Emergency Medicine (ZAE) with Centralized Endoscopy Service, Klagenfurt, Austria
,
M Kutilek
2   University Hospital St. Pölten, Department of Internal Medicine 2, St. Pölten, Austria
,
G Essler
1   Klinikum Klagenfurt am Wörthersee, Department of Internal Medicine and Gastroenterology (IMuG), Hepatology, Endocrinology, Rheumatology and Nephrology and Emergency Medicine (ZAE) with Centralized Endoscopy Service, Klagenfurt, Austria
,
J Weber-Eibel
1   Klinikum Klagenfurt am Wörthersee, Department of Internal Medicine and Gastroenterology (IMuG), Hepatology, Endocrinology, Rheumatology and Nephrology and Emergency Medicine (ZAE) with Centralized Endoscopy Service, Klagenfurt, Austria
,
A Maieron
2   University Hospital St. Pölten, Department of Internal Medicine 2, St. Pölten, Austria
,
M Peck-Radosavljevic
1   Klinikum Klagenfurt am Wörthersee, Department of Internal Medicine and Gastroenterology (IMuG), Hepatology, Endocrinology, Rheumatology and Nephrology and Emergency Medicine (ZAE) with Centralized Endoscopy Service, Klagenfurt, Austria
› Author Affiliations
Further Information

Publication History

Publication Date:
23 April 2020 (online)

 

Aims to investigate the accuracy of flexible nitinol FNA and EUS-FNB needle for pancreatic masses in 2 Austrian centers(Klagenfurt and St.Pölten).

Methods Our bicentric study included EUS biopsies of pancreatic masses performed between 02/2017-03/2019-Klagenfurt and between 11/2018-03/2019-St.Pölten. Olympus (19 or 22 G)flexible nitinol needle were used for EUS-FNA and SharkCore (19 or 22 G) or Boston Acquire (22 G) were used for EUS-FNB.

Needles were chosen according to the availability in the centers or endoscopist preference.

124patients with 134EUS-FNA/FNB(Klagenfurt −90,St. Pölten-44) of solid pancreatic masses were enrolled in this retrospective study.Final diagnosis was established through a combination of histopathology, surgery, radiological findings, autopsy and clinical follow-up.

The accuracy was calculated as the proportion of true positive + true negative cases/total number of cases, while Se for malignancy represented the rate of true positive samples/all malignant cases.

Positive EUS-FNA/FNB was defined as the finding of at least atypical cells with dysplasia.

An“experienced”endosonographer had performed at least 225 EUS including 50 interventions (at least 25 performed for pancreatic tumors).

Results The mean age of patients was 64.9 ± 14.8 years(55.6% male).The most common final diagnosis was adenocarcinoma(61,2%), following by and pseudotumor due to chronic pancreatitis(11.2%) and inflammation(10.4%).Overall, 70.9% of cases presented with malignancy.

The EUS-FNA needle were used in 64/83(56.7%) cases.Trainees performed 51.4%of all EUS.

The overall accuracy and Se for detecting malignancy were:77.6% and 66.1%,respectively.

The accuracy and Se for malignancy for EUS-FNB was significantly higher as compared with EUS-FNA needles: 86.2% vs.71%, p = 0.04 and 85% vs.64.2%, p = 0.04.

The use of EUS-FNB needles by experienced endosonographers was associated with 90% Se for malignancy

Tab. 1

Accuracy

Se for malignancy

Experienced endosonographers/Trainees

FNA:14/19(73.6%) vs. FNB:41/46(89.1%),p = 0.23/FNA:40/57(70.1%)vs. FNB:9/12(75%),p = 0.99

FNA:9/14(64.2%)vs. FNB:27/30(90%),p = 0.09/FNA:27/42(64.2%)vs. FNB:7/10(70%),p = 0.78

Conclusions The use of EUS-FNB needles in centers without on-site pathologist is associated with increased accuracy for EUS-guided biopsy of solid pancreatic masses, especially when there are used by experienced endosonographers