TRAINING MODULES FOR CONFOCAL ENDOMICROSCOPY (CLE) PATTERNS OF PANCREATIC CYSTIC LESIONS (PCLS) RESULTS IN SUSTAINED LEARNING AND ACCURACY IN DIAGNOSIS FOR EARLY CAREER ADVANCED ENDOSCOPISTS

Aims Demonstrate the impact of audiovisual training modules of CLE patterns for early EUS users and assess the durability of training.

Methods Twenty-one gastroenterologists naïve to CLE with varying EUS experience watched a 20-minute audiovisual teaching module outlying the CLE imaging criteria to characterize PCLs. PHASE 1: Participants then watched 80 edited videos with representative EUS-CLE patterns of PCLs with confirmed histopathology. Feedback about cyst histology was provided.Observers were then randomized 1:1 for a refresher feedback session (to review 20 different CLE videos at 4 weeks). PHASE 2: Eight weeks after the initial session, all observers assessed the same 80 videos presented in a different sequence.

Results PHASE 1: progressing through blocks of 20 videos, observers improved their diagnostic accuracy, interobserver agreement (IOA), and degree of confidence to differentiate mucinous from non-mucinous PCLs and specific cyst types (p<0.001, Table 1). Observers distinguished mucinous from non-mucinous PCLs with high sensitivity (86%), specificity (82%), accuracy (85%), confidence (76%), and IOA (k=0.67).

PHASE 2: After 8 weeks, the sensitivity (90%), accuracy (89%), high confidence (83%), and IOA (k=0.75) to classify mucinous vs. non-mucinous PCLs significantly improved (p<0.05), suggesting durability of initial training ([ Figure 1 ]). The diagnostic accuracy of EUS-nCLE for all PCL types was>80% (IPMN: 84%, MCN: 82%, pseudocyst: 96%, SCA: 86%, NET/SPN: 84%). The addition of a refresher feedback session did not modify the results.

Fig. 1

Conclusions A teaching intervention for early career endosonographers in CLE image interpretation for classifying PCLs results in durable learning and highly accurate diagnoses of PCLs.

Publication History

Article published online:
14 April 2022