Diagnostic yield of the SharkCore EUS-guided fine-needle biopsy.

Published on Jul 1, 2019in Journal of the American Society of Cytopathology
· DOI :10.1016/J.JASC.2019.03.001
Megan J. Fitzpatrick7
Estimated H-index: 7
(Harvard University),
Yasmin G. Hernandez-Barco3
Estimated H-index: 3
(Harvard University)
+ 3 AuthorsMartha B. Pitman53
Estimated H-index: 53
(Harvard University)
Sources
Abstract
Introduction Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is the standard diagnostic procedure for many intrathoracic and intra-abdominal lesions. Next-generation fine-needle biopsies (FNBs) can increase diagnostic yield by procuring tissue suitable for histological processing. We evaluate the diagnostic yield and operating characteristics of the SharkCore (SC; Medtronic Corp., Minneapolis, MN) FNB in a tertiary referral facility. Materials and methods We performed a single-center retrospective review of SC-FNB–acquired tissue between January 2014 and March 2018. Patient demographic data, endoscopic features, and pathology data were obtained from the electronic medical record. Diagnostic yield was assessed by the ability to obtain a definitive diagnosis, defined as malignant or benign interpretations. Operating characteristics were also calculated. Results A total of 179 lesions were sampled with the SC-FNB in 157 patients (mean age: 63 years, 57% male). Of these, 31 lesions were concomitantly sampled with a conventional FNA needle. Most lesions were pancreatic (49%). Diagnostic yield was 86%, which was independent of lesion location, lesion size and needle gauge. Diagnostic accuracy was highest when both histology and cytology specimens were analyzed concurrently (96.5%). In patients with a history of chronic pancreatitis, accuracy, sensitivity, and negative predictive value were reduced (71.4%, 20.0%, and 69.2%, respectively). Rapid onsite evaluation (ROSE) occurred in 64.8% of cases and was more likely to be diagnostic at the time of rapid evaluation if SC-acquired tissue was utilized versus FNA-acquired tissue (P = 0.03); however, final diagnostic yield did not differ between needles (P = 0.13). Conclusions SC-FNB shows high diagnostic yield and accuracy and provides diagnostic tissue for ROSE. SC-FNB is an effective alternative to conventional FNA.
📖 Papers frequently viewed together
201819.82Gut
4 Authors (Nazar Aslam, ..., Venkat Mahesh)
201719.82Gut
References25
Newest
#1F Vitali (FAU: University of Erlangen-Nuremberg)H-Index: 8
#2Deike StrobelH-Index: 32
Last. Dane WildnerH-Index: 16
view all 12 authors...
Aims: Endosonography (EUS) is one of the main diagnostic tools for the differential diagnosis of pancreatic masses. The aim of our study was to describe the value of this technique in the work-up of solid pancreatic lesions, considering the influence of the morphological evidence of pancreatic inflammation in the diagnostic process. Material and methods: Retrospective analysis of prospectively collected data in our tertiary University center. From March 2007 to October 2015, 218 patients underwe...
5 CitationsSource
#1Ying Huang (PRC: China Medical University (PRC))H-Index: 6
#2Jingwen Shi (PRC: China Medical University (PRC))H-Index: 1
Last. Kao Li (PRC: China Medical University (PRC))H-Index: 1
view all 4 authors...
Abstract Few studies have evaluated the performance of percutaneous core needle biopsies of the pancreas. This article is an overview of the advantages, disadvantages, predictive power and complications associated with percutaneous ultrasound-guided core needle biopsies of pancreatic lesions. A comprehensive literature search of Medline (using PubMed as the search engine) and EMBASE was done to identify suitable studies up to March 2017. A study of quantitative pre-operative pancreatic biopsy da...
10 CitationsSource
#1Michael Hareskov Larsen (OUH: Odense University Hospital)H-Index: 8
#1Michael Larsen (OUH: Odense University Hospital)H-Index: 62
Last. Michael Bau Mortensen (OUH: Odense University Hospital)H-Index: 20
view all 4 authors...
Background and study aim Due to the scarcity of specific data on endoscopic ultrasound (EUS)-guided fine-needle biopsies (SharkCore) FNB in the evaluation of pancreatic lesions, we performed a prospective study of the diagnostic performance of EUS SharkCore FNB in patients with pancreatic lesions. The aim of this study was to evaluate the diagnostic accuracy. Patients and methods Single-center prospective study of 41 consecutive patients referred for EUS-FNB from October 2015 to April 2016 at ou...
18 CitationsSource
#1DouglasG Adler (UofU: University of Utah)H-Index: 2
#1Mariam Naveed (UI: University of Iowa)H-Index: 9
Last. Douglas G. Adler (UofU: University of Utah)H-Index: 65
view all 13 authors...
Background and Objectives: The ability to obtain adequate tissue of solid pancreatic lesions by EUS-guided remains a challenge. The aim of this study was to compare the performance characteristics and safety of EUS-FNA for evaluating solid pancreatic lesions using the standard 22-gauge needle versus a novel EUS biopsy needle. Methods: This was a multicenter retrospective study of EUS-guided sampling of solid pancreatic lesions between 2009 and 2015. Patients underwent EUS-guided sampling with a ...
25 CitationsSource
#1Takuya Ishikawa (Nagoya University)H-Index: 2
#1Takuya Ishikawa (Nagoya University)H-Index: 14
Last. Paul J. Belletrutti (U of C: University of Calgary)H-Index: 7
view all 8 authors...
Background As endoscopic ultrasound-guided tissue acquisition techniques evolve, there is increasing interest in obtaining optimal histological samples to improve diagnostic accuracy. In this study, we aimed to assess the tissue acquisition success rate and test performance characteristics of a novel endoscopic ultrasound-guided fine needle biopsy (EUS-FNB) system.
12 CitationsSource
#1Muhammad Ali Khan (UTHSC: University of Tennessee Health Science Center)H-Index: 3
#1Muhammad Ali Khan (UTHSC: University of Tennessee Health Science Center)H-Index: 26
Last. Todd H. Baron (UNC: University of North Carolina at Chapel Hill)H-Index: 114
view all 7 authors...
Background The diagnostic yield of endoscopic ultrasound (EUS) guided fine-needle aspiration (FNA) is variable, and partly dependent upon rapid onsite evaluation (ROSE) by a cytopathologist. Second generation fine-needle biopsy (FNB) needles are being increasingly used to obtain core histological tissue samples. Aims Studies comparing the diagnostic yield of EUS guided FNA versus FNB have reached conflicting conclusions. We therefore conducted a systematic review and meta-analysis to compare the...
83 CitationsSource
#1Manol Jovani (Harvard University)H-Index: 15
#2Wasif M. Abidi (Brigham and Women's Hospital)H-Index: 9
Last. Linda S. Lee (Brigham and Women's Hospital)H-Index: 21
view all 3 authors...
AbstractBackground: There are very few available data on the novel SharkCore™ needles for EUS-FNB.Aim: Comparison of the performance of the SharkCore™ needles with the standard EUS-FNA needles for the diagnosis of solid upper GI masses.Patients and methods: Single-center, retrospective cohort study in an academic tertiary referral hospital. Patients were matched 1:1 for the site of the lesion and the presence or absence of rapid on-site evaluation (ROSE).Results: A total of 102 patients were inc...
31 CitationsSource
#1Pujan Kandel (Mayo Clinic)H-Index: 10
#2Ghassan Tranesh (Mayo Clinic)H-Index: 4
Last. Michael B. Wallace (Mayo Clinic)H-Index: 86
view all 8 authors...
Background and Aims EUS-guided fine needle biopsy (FNB) sampling and FNA are important methods for obtaining core tissues and cytologic aspirates. To improve the specimen quality for pathologic evaluation, a novel EUS-FNB Shark Core (SC) needle has been designed to acquire core tissue during EUS procedures. We compared the histology yield of EUS-FNB sampling using the SC needle (EUS-FNB-SC) to EUS-FNA in patients who had solid pancreatic and nonpancreatic lesions. Methods This was a retrospectiv...
99 CitationsSource
#1Christopher J. DiMaio (ISMMS: Icahn School of Medicine at Mount Sinai)H-Index: 17
#2Jennifer M. Kolb (ISMMS: Icahn School of Medicine at Mount Sinai)H-Index: 10
Last. Douglas G. Adler (UofU: University of Utah)H-Index: 65
view all 35 authors...
Background and aims: The ability to safely and effectively obtain sufficient tissue for pathologic evaluation by using endoscopic ultrasound (EUS) guidance remains a challenge. Novel designs in EUS needles may provide for improved ability to obtain such core biopsies. The aim of this study was to evaluate the diagnostic yield of core biopsy specimens obtained using a novel EUS needle specifically designed to obtain core biopsies. Patients and methods: Multicenter retrospective review of all EUS-...
56 CitationsSource
#1Douglas G. Adler (UofU: University of Utah)H-Index: 65
#2Benjamin L. Witt (UofU: University of Utah)H-Index: 17
Last. Robert L. Schmidt (UofU: University of Utah)H-Index: 30
view all 7 authors...
Background and Objectives: Standard endoscopic ultrasound-fine-needle aspiration (EUS-FNA) needles are in widespread use. Meaningful differences between the available needles have been difficult to identify. Recently, a new EUS needle (Shark Core®, Covidien, Dublin, Leinster, Ireland), has been introduced in an attempt to improve diagnostic accuracy, tissue yield, and to potentially obtain a core tissue sample. We performed a pilot study prospectively to evaluate this new needle when compared to...
41 CitationsSource
Cited By7
Newest
#1Swati Satturwar (University of Pittsburgh)H-Index: 4
#2Liron Pantanowitz (UM: University of Michigan)H-Index: 57
Last. Liron Pantanowitz (UM: University of Michigan)H-Index: 7
view all 2 authors...
Cell-block preparations have become an essential part of integrated cytology diagnosis. They are essentially microbiopsies that are formalin fixed and embedded in paraffin. This has become more prevalent with greater sample procurement due to the advent of newer biopsy techniques and needles. Cell-blocks allow retrieval of small tissue fragments from cytology specimens that sometimes cannot be processed by alternate cytologic techniques. They represent concentrated, cell-enriched preparations th...
2 CitationsSource
#1Michael J. Thrall (Houston Methodist Hospital)H-Index: 15
#2Colleen M. VrbinH-Index: 11
Last. Daniel F.I. Kurtycz (UW: University of Wisconsin-Madison)H-Index: 19
view all 8 authors...
Abstract Introduction The introduction of a new generation of core needle biopsies (CNBs) for endoscopic procedures has prompted reconsideration of the role of cytopathologists in the handling of small biopsies. The ASC has therefore conducted a survey with the intention of elucidating current practices regarding the handling of small CNBs. Materials and Methods The membership of the ASC was invited by email to participate in an online survey over a 2-month period. The survey consisted of 20 mul...
2 CitationsSource
#1Dajun YuH-Index: 1
#2Xiaolan LiH-Index: 1
Last. Jiejun Hu (CQMU: Chongqing Medical University)H-Index: 1
view all 6 authors...
Left-sided portal hypertension (LSPH) is an extremely rare clinical syndrome, and it is the only form of curable portal hypertension. It is primarily caused by pancreatic disease, and is associated with complications that cause spleen vein compression. Specific symptoms are often lacking, rendering it difficult to diagnose. Splenectomy is the main treatment for cases complicated by variceal bleeding, and the effects of treatment primarily depend on the condition of the primary disease. The patie...
1 CitationsSource
#1Megan J. Fitzpatrick (Harvard University)H-Index: 7
#2Yasmin G. Hernandez-Barco (Harvard University)H-Index: 3
Last. Martha B. Pitman (Harvard University)H-Index: 53
view all 5 authors...
Abstract Background Pancreatic endoscopic ultrasound-guided fine needle biopsy (EUS-FNB) acquires both direct smear and small core biopsy specimens. Triage protocols for pancreatic FNBs to cytopathology (CP) or gastrointestinal surgical pathologist (GIP) is controversial and varies by institution. Material and Methods Pancreatic EUS-FNBs obtained with the SharkCoreTM FNB were reviewed between January 2014 and June 2019. Specimen characteristics and pathology data including tissue triage were obt...
1 CitationsSource
#1Mauro SaiegH-Index: 13
#1Mauro Ajaj SaiegH-Index: 1
Last. Martha B. Pitman (Harvard University)H-Index: 53
view all 2 authors...
The Papanicolaou Society of Cytopathology developed a set of guidelines for reporting pancreaticobiliary cytology in 2014 (PB System), with a six-tiered system: Nondiagnostic, Negative, Atypical, Neoplastic (Benign or Other), Suspicious, and Positive. This proposed scheme incorporates ancillary testing such as biochemical testing of cyst fluids for diagnosis and provides terminology that standardizes the category of the various diseases of the pancreas, some of which are difficult to diagnose sp...
4 CitationsSource
#1De-Feng Li (JNU: Jinan University)H-Index: 5
#2Jian-Yao Wang (Boston Children's Hospital)H-Index: 6
Last. Jun Yao (JNU: Jinan University)H-Index: 9
view all 11 authors...
BACKGROUND AND AIM: Endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) is used to diagnose lesions within or adjacent to the digestive tract. However, there is no report on the overall diagnostic accuracy, technical success, and adverse events of FNB. The aims of this study were to conduct a systematic review and meta-analysis to comprehensively assess the diagnostic accuracy, technical success, and adverse events of FNB. METHODS: Pubmed, Embase, and Cochrane Library databases were search...
7 CitationsSource
#1Jacob Sweeney (NewYork–Presbyterian Hospital)H-Index: 1
#1Jacob Sweeney (NewYork–Presbyterian Hospital)H-Index: 3
Last. Abha Goyal (NewYork–Presbyterian Hospital)H-Index: 10
view all 3 authors...
BACKGROUND: Although endoscopic ultrasound guided fine-needle biopsy (EUS-FNB) has emerged as an alternative to fine-needle aspiration (FNA) for the sampling of solid pancreatic mass lesions, it remains unclear which method is more effective. We compared the diagnostic yields of FNA, FNB, and combined FNA/FNB at a tertiary care institution. METHODS: Specimens from EUS-FNA (04/2014-08/2017) and EUS-FNB (10/2015-08/2017) with SharkCore needle of pancreatic solid mass lesions were retrieved. Clinic...
3 CitationsSource