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Article

Optimal Techniques for EUS-Guided Fine-Needle Aspiration of Pancreatic Solid Masses at Facilities without On-Site Cytopathology: Results from Two Prospective Randomised Trials

1
Department of Internal Medicine and Liver Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, Seoul 03080, Korea
2
Department of Internal Medicine, Inje University Haeundae Paik Hospital, Busan 48108, Korea
3
Department of Pathology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea
4
Department of Clinical Epidemiology and Biostatics, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea
5
Division of Gastroenterology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, Korea
6
Digestive Diseases Research Center, University of Ulsan College of Medicine, Seoul 05505, Korea
*
Author to whom correspondence should be addressed.
These authors contributed equally to this work as first authors.
Academic Editors: Stanley W. Ashley and Hidekazu Suzuki
J. Clin. Med. 2021, 10(20), 4662; https://doi.org/10.3390/jcm10204662
Received: 11 July 2021 / Revised: 17 September 2021 / Accepted: 8 October 2021 / Published: 12 October 2021
(This article belongs to the Section Gastroenterology & Hepatopancreatobiliary Medicine)
Background: EUS-guided fine-needle aspiration (EUS-FNA) has emerged as the primary modality for the cytologic diagnosis of pancreatic solid masses. The aim of this study is to determine whether technical factors including suction (S), non-suction (NS), capillary sampling with stylet slow-pull (CSSS), and the number of needle actuations (to-and-fro needle movements) may affect the accuracy of EUS-FNA for pancreatic solid masses at facilities without on-site cytopathology. Methods: The diagnostic yield of malignancy, blood contamination and cellularity at each sample acquired from EUS-FNA with or without S and different numbers of actuation (10, 15 and 20) were measured (study I). The optimal actuation number was determined and a head-to-head comparison trial between S and CSSS was performed (study II). Results: In study I, significant blood contamination was seen using S with 20 compared with 15 actuations (p = 0.002). Diagnostic yield of malignancy was not significantly different between 10, 15, and 20 actuations with S, whereas it was statistically higher for 15 actuations compared with 10 actuations with NS (p = 0.001). In study II, no difference was noted in diagnostic yield with 15 actuations between S and CSSS (88% vs. 90%, p = 0.74). Conclusions: Increasing actuation in NS resulted in a better diagnostic yield for EUS-FNA without significant blood contamination, whereas increasing actuation in S did not change the diagnostic yield of EUS-FNA while causing significant blood contamination. With 15 actuations, the diagnostic yield was comparable between S and CSSS. View Full-Text
Keywords: EUS; fine-needle aspiration; pancreatic neoplasm; suction EUS; fine-needle aspiration; pancreatic neoplasm; suction
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MDPI and ACS Style

Paik, W.H.; Choi, J.H.; Park, Y.; Lee, J.B.; Park, D.H. Optimal Techniques for EUS-Guided Fine-Needle Aspiration of Pancreatic Solid Masses at Facilities without On-Site Cytopathology: Results from Two Prospective Randomised Trials. J. Clin. Med. 2021, 10, 4662. https://doi.org/10.3390/jcm10204662

AMA Style

Paik WH, Choi JH, Park Y, Lee JB, Park DH. Optimal Techniques for EUS-Guided Fine-Needle Aspiration of Pancreatic Solid Masses at Facilities without On-Site Cytopathology: Results from Two Prospective Randomised Trials. Journal of Clinical Medicine. 2021; 10(20):4662. https://doi.org/10.3390/jcm10204662

Chicago/Turabian Style

Paik, Woo H., Joon H. Choi, Yangsoon Park, Jung B. Lee, and Do H. Park 2021. "Optimal Techniques for EUS-Guided Fine-Needle Aspiration of Pancreatic Solid Masses at Facilities without On-Site Cytopathology: Results from Two Prospective Randomised Trials" Journal of Clinical Medicine 10, no. 20: 4662. https://doi.org/10.3390/jcm10204662

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