Background and study aims: The fanning technique for endoscopic ultrasound-guided fine-needle aspiration (EUS – FNA)
involves sampling multiple areas within a lesion with each pass. The aim of this study
was to compare the fanning and standard techniques for EUS – FNA of solid pancreatic
masses.
Patients and methods: Consecutive patients with solid pancreatic mass lesions were randomized to undergo
EUS – FNA using either the standard or the fanning technique. The main outcome measure
was the median number of passes required to establish diagnosis. The secondary outcome
measures were the diagnostic accuracy, technical failure, and complication rate of
the two techniques.
Results: Of 54 patients, 26 were randomized to the standard technique and 28 to the fanning
technique. There was no difference in diagnostic accuracy (76.9 % vs. 96.4 %; P = 0.05), technical failure or complication rates (none in either cohort). There was
a significant difference in both the number of passes required to establish diagnosis
(median 1 [interquartile range 1 – 3] vs. 1 [1 – 1]; P = 0.02) and the percentage of patients in whom a diagnosis was achieved on pass one
(57.7 % vs. 85.7 %; P = 0.02) between the standard and fanning groups, respectively.
Conclusions: The fanning technique of FNA was superior to the standard approach because fewer
passes were required to establish the diagnosis. If these promising data are confirmed
by other investigators, consideration should be given to incorporating the fanning
technique into routine practice of EUS – FNA.
Registered at Clinical Trials.gov (NCT 01501903).
