Comparison between EUS-guided fine-needle aspiration cytology and EUS-guided fine-needle biopsy histology for the evaluation of pancreatic neuroendocrine tumors.

Published on Mar 1, 2021in Pancreatology3.629
· DOI :10.1016/J.PAN.2020.12.015
Stefano Francesco Crinò14
Estimated H-index: 14
Serena Ammendola3
Estimated H-index: 3
+ 13 AuthorsErminia Manfrin24
Estimated H-index: 24
Abstract Background/objectives Studies comparing EUS-guided fine-needle aspiration (EUS-FNA) with EUS-guided fine-needle biopsy (EUS-FNB) for the evaluation of pancreatic neuroendocrine tumors (pNETs) are lacking. We aimed at comparing EUS-FNA with EUS-FNB in terms of Ki-67 proliferative index (PI) estimation capability, cellularity of the samples, and reliability of Ki-67 PI/tumor grading compared with surgical specimens. Methods Patients diagnosed with pNETs on EUS and/or surgical specimens were retrospectively identified. Specimens were re-evaluated to assess Ki-67 PI feasibility, sample cellularity by manual counting, and determination of Ki-67 PI value. Outcomes in the EUS-FNA and EUS-FNB groups were compared. Kendall rank test was used for Ki-67 PI correlation between EUS and surgical specimens. Subgroup analysis including small (≤20 mm), non-functioning pNETs was performed. Results Three-hundred samples from 292 lesions were evaluated: 69 EUS-FNA cytology and 231 EUS-FNB histology. Ki-67 PI feasibility was similar for EUS-FNA and EUS-FNB (91.3% vs. 95.7%, p = 0.15), while EUS-FNB performed significantly better in the subgroup of 179 small pNETs (88.2% vs. 96.1%, p = 0.04). Rate of poor cellulated ( Conclusion Our study showed stronger correlation for Ki-67 values between EUS-FNB and surgical specimens, and that EUS-FNB outperformed EUS-FNA in the evaluation of small pNETs. EUS-FNB should become standard of care for grading assessment of suspected pNETs.
📖 Papers frequently viewed together
99 Citations
28 Authors (Yen-I. Chen, ..., Clarence Wong)
5 Citations
8 Citations
Background and Study Aims On contrast-enhanced imaging studies, nonhypovascular (i. e., isovascular and hypervascular) patterns can be observed in solid pancreatic lesions (SPLs) of different nature, prognosis, and management. We aimed to identify endoscopic ultrasound (EUS) features of nonhypovascular SPLs associated with malignancy/aggressiveness. The secondary aims were EUS tissue acquisition (EUS-TA) outcome and safety in this setting of patients. Patients and Methods This prospective observ...
6 CitationsSource
#1Priscilla A. van Riet (Erasmus University Medical Center)H-Index: 5
#2Nicole S. Erler (EUR: Erasmus University Rotterdam)H-Index: 16
Last. Djuna L. Cahen (Erasmus University Medical Center)H-Index: 26
view all 4 authors...
BACKGROUND EUS-guided tissue acquisition is extensively used, but the optimal sampling device is still a matter of debate. We performed a meta-analysis on studies comparing FNA to FNB needles, in addition to a mutual comparison of FNB needles. METHODS Online databases were searched for randomized controlled studies of at least 50 cases with a suspected solid pancreatic or non-pancreatic lesion that compared FNA to FNB ProCore, SharkCore, or Acquire needles. Outcome measures included diagnostic a...
9 CitationsSource
Abstract Background and aims The aim of this study was to compare the performance of EUS-guided fine-needle biopsy using fork-tip (SharkCore, Medtronic, USA) or side-fenestrated (ProCore, Cook Medical, Limerick, Ireland) needles in patients with solid pancreatic lesions. Methods This is a randomized controlled study conducted in a single academic center, including patients who underwent sampling with the fork-tip or the side-fenestrated 22-gauge or 25-gauge needles. Three passes were performed, ...
16 CitationsSource
#1Salvatore PaiellaH-Index: 23
#2Luca LandoniH-Index: 19
Last. Roberto SalviaH-Index: 52
view all 19 authors...
Background Data on the reliability of the Ki-67 index and grading calculations from endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) of pancreatic neuroendocrine tumors (PanNETs) are controversial. We aimed to assess the accuracy of these data compared with histology. Methods Cytological analysis from EUS-FNA in patients with suspected PanNETs (n = 110) were compared with resection samples at a single institution. A minimum of 2000 cells were considered to be adequate for grading. C...
4 CitationsSource
Background and study aims Current ESGE guidelines suggest employing the suction (SU) technique for endoscopic ultrasound (EUS)-guided sampling of pancreatic solid lesions. Nonetheless, recent randomized controlled trials (RCT) have reported that the slow-pull (SP) technique has similar diagnostic accuracy with possibly less blood contamination. However, these results are heterogeneous and limited to small cohorts. The aim of this meta-analysis was to compare adequacy, accuracy, sensitivity and s...
4 CitationsSource
#1John S. LeedsH-Index: 21
#1John S. LeedsH-Index: 13
Last. Kofi OppongH-Index: 22
view all 8 authors...
Background and study aims Pancreatic neuroendocrine tumors (PanNETs) outcomes are dependent upon grading by Ki67. This study compared endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) to fine-needle aspiration (FNA) in assessing PanNETs. Patients and methods All pancreatic histology for PanNET between January 2009 and June 2017 was included if EUS sampling was performed prior to surgical resection. Ki67 and grade from FNA and FNB samples was compared to surgical histology using correlati...
8 CitationsSource
#1Antonio Facciorusso (University of Foggia)H-Index: 19
#2Valentina Del Prete (University of Foggia)H-Index: 13
Last. Nicola Muscatiello (University of Foggia)H-Index: 22
view all 6 authors...
Background and study aims Although newer needle designs are thought to improve diagnostic outcomes of endoscopic ultrasound-guided fine-needle biopsy, there is limited evidence on their diagnostic performance. The aim of this meta-analysis was to provide a pooled estimate of the diagnostic performance and safety profile of Franseen and Fork-tip fine-needle biopsy needles. Patients and methods Computerized bibliographic search on the main databases was performed through March 2019. The primary en...
25 CitationsSource
#1Milena Di Leo (Humanitas University)H-Index: 17
Last. Silvia CarraraH-Index: 12
view all 17 authors...
Abstract Background and aim Endoscopic ultrasound-guided sampling (EUS sampling) is a safe and effective technique. The study aim was to evaluate the presence of a histological core from pancreatic lesions using a new 25G fork-tip needle. Methods Observational multicenter prospective and analytical study, including consecutive patients with solid pancreatic masses referred for EUS-guided sampling. At each needle pass, the endoscopist performed macroscopic on-site evaluation (MOSE). The primary o...
18 CitationsSource
#1Stefano PartelliH-Index: 43
#2Michele MazzaH-Index: 4
Last. Massimo FalconiH-Index: 105
view all 7 authors...
Abstract Background International guidelines suggest a watchful strategy for small nonfunctioning pancreatic neuroendocrine tumors. The aim of this study was to evaluate the management and indications for surgery in patients with asymptomatic nonfunctioning pancreatic neuroendocrine tumors ≤2 cm. Methods Patients with asymptomatic, incidental, sporadic nonfunctioning pancreatic neuroendocrine tumors ≤2 cm without nodal or distant metastases were included (2012–2016). A comparison between active ...
19 CitationsSource
#1Massimo MilioneH-Index: 31
#2Patrick Maisonneuve (IEO: European Institute of Oncology)H-Index: 134
Last. Vincenzo Mazzaferro (University of Milan)H-Index: 89
view all 11 authors...
Abstract In pancreatic neuroendocrine neoplasms (pNEN), size ≤2 cm and Ki-67 20%. Tumor size (≤2 vs. >2 cm) was not a predictive factor at any analysis. Intra-class correlation of Ki-67 values on pre-surgical biopsies vs. surgical specimens was 0.99 and Ki-67 classes were correctly identified in 97% of biopsies. Ki-67 and presence of liver metastases are the major prognostic factors in pNEN and identify different progression risks regardless of tumor size. Pre-surgical pNEN biopsy for Ki-67 asse...
6 CitationsSource
Cited By4
#1Yuhei Iwasa (Gidai: Gifu University)H-Index: 4
#2Takuji Iwashita (Gidai: Gifu University)H-Index: 26
Last. Takeshi Hara (Gidai: Gifu University)H-Index: 37
view all 0 authors...
Background: Contrast-enhanced endoscopic ultrasound (CE-EUS) is useful for the differentiation of pancreatic tumors. Using deep learning for the segmentation and classification of pancreatic tumors might further improve the diagnostic capability of CE-EUS. Aims: The aim of this study was to evaluate the capability of deep learning for the automatic segmentation of pancreatic tumors on CE-EUS video images and possible factors affecting the automatic segmentation. Methods: This retrospective study...
#1Antonio Facciorusso (University of Foggia)H-Index: 19
#2Daryl Ramai (Brooklyn Hospital Center)H-Index: 9
Last. Stefano Francesco CrinòH-Index: 14
view all 7 authors...
There is scarce and conflicting evidence on the comparison between endoscopic ultrasound (EUS) and percutaneous (PC)-guided liver biopsy (LB). The aim of this study was to compare the two approaches in a series of patients with parenchymal and focal liver lesions. Fifty-four patients undergoing EUS-LB in two high-volume centers between 2017 and 2021 were compared to 62 patients who underwent PC-LB. The primary outcome was diagnostic adequacy rate. The secondary outcomes were diagnostic accuracy,...
Pancreatic neuroendocrine neoplasms (PanNENs) are relatively rare, but their incidence has increased significantly in the last decades. Precise diagnosis and prognostic stratification are crucial for proper patient management. Endoscopic ultrasound (EUS) is the modality of choice for diagnosis of solid pancreatic tumors, showing a higher tumor detection rate than other imaging modalities, especially for small size lesions. EUS also serves as a guide for preoperative sampling and other interventi...
#2Roberto Di MitriH-Index: 11
Last. Gloria Fernández-Esparrach (University of Barcelona)H-Index: 33
view all 48 authors...
ABSTRACT null null Background and aims null Benefit of rapid on-site evaluation (ROSE) on diagnostic accuracy of endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) has never been evaluated in a randomized study. This trial aimed to test the hypothesis that in solid pancreatic lesions (SPLs), diagnostic accuracy of EUS-FNB without ROSE was not inferior to that of EUS-FNB with ROSE. null null null Methods null Non-inferiority study (non-inferiority margin 5%) conducted at 14 centers in eigh...
2 CitationsSource
#1Pablo Cortegoso Valdivia (UNITO: University of Turin)H-Index: 3
#1Pablo Cortegoso Valdivia (University of Parma)H-Index: 1
Last. Claudio De Angelis (UNITO: University of Turin)H-Index: 22
view all 3 authors...