PROVIDING THE PATHOLOGIST WITH CLINICAL INFORMATION IMPROVES THE READING AND INTERPRETATION OF EUS-GUIDED TISSUE ACQUISITION OF SOLID PANCREATIC LESIONS

Aims EUS-guided tissue acquisition is the most sensitive method to collect tissue samples of solid pancreatic lesions. The availability of clinical information might aid the pathologist’s ability to establish a diagnosis. The aim of this study was to investigate the diagnostic accuracy and agreement of cytotechnicians and pathologists in the evaluation of EUS-FNA samples of solid pancreatic lesions and the impact of clinical information on agreement and diagnostic accuracy.

Methods Forty EUS-FNA smears were collected retrospectively and reviewed by eight cytotechnicians and sixteen pathologists. After a month, all participants reviewed the smears again, but in a different order. Clinical information was available in half of the cases in the first round, and for the other half of the cases in the second round. The participants were blinded to the purpose of this study. The diagnostic accuracy is described as the proportion of smears that is correct, compared to the final follow-up diagnosis. Inter-observer agreements are calculated using unweighted Fleiss’ kappa statistics.

Results The diagnostic accuracy based on smears only was significantly higher with clinical information compared to without clinical information (45% versus 38%, p-value 0.002). The overall agreement among participants without clinical information was fair (κ 0.225). With clinical information the overall agreement was significantly higher compared to the agreement without clinical information (κ 0.271, p-value of the difference=0.018).

Conclusions Adding clinical information to the pathology requisition form improves the diagnostic reproducibility and diagnostic accuracy of EUS-FNA smears of solid pancreatic lesions.

Publication History

Article published online:
14 April 2022