Macroscopic on-site evaluation (MOSE) of specimens from solid lesions acquired during EUS-FNB: multicenter study and comparison between needle gauges.

Published on May 27, 2021in Endoscopy International Open
· DOI :10.1055/A-1395-7129
Benedetto Mangiavillano20
Estimated H-index: 20
,
Leonardo Frazzoni21
Estimated H-index: 21
+ 14 AuthorsAlessandro Repici71
Estimated H-index: 71
Source
Abstract
Background and study aims  The standard method for obtaining samples during endoscopic ultrasonography (EUS) is fine-needle aspiration (FNA), the accuracy of which can be affected by the presence of a cytopathologist in endoscopy room (rapid on-site evaluation [ROSE]). With the introduction of fine-needle biopsy (FNB), macroscopic on-site evaluation (MOSE) of a acquired specimen has been proposed. Only a few studies have evaluated the role of MOSE and in all except one, a 19G needle was used. Our primary aim was to evaluate the diagnostic yield and accuracy of MOSE with different needle sizes and the secondary aim was to identify factors influencing the yield of MOSE. Patients and methods  Data from patients who underwent EUS-FNB for solid lesions, with MOSE evaluation of the specimen, were collected in six endoscopic referral centers. Results  A total of 378 patients (145 F and 233 M) were enrolled. Needles sizes used during the procedures were 20G (42 %), 22G (45 %), and 25G (13 %). The median number of needle passes was two (IQR 2-3). The overall diagnostic yield of MOSE was of 90 % (confidence interval [CI] 86 %-92 %). On multivariable logistic regression analysis, variables independently associated with the diagnostic yield of MOSE were a larger needle diameter (20G vs. 25G, OR 11.64, 95 %CI 3.5-38.71; 22G vs. 25G, OR 6.20, 95 %CI 2.41-15.90) and three of more needle passes (OR 3.39, 95 %CI 1.38-8.31). Conclusions  MOSE showed high diagnostic yield and accuracy. Its yield was further increased if performed with a large size FNB needles and more than two passes.
References21
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#2Nicole S. Erler (EUR: Erasmus University Rotterdam)H-Index: 16
Last. Djuna L. Cahen (Erasmus University Medical Center)H-Index: 26
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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...
12 CitationsSource
Background and study aims Pancreatic cancer represents the fourth most common cause of cancer-related deaths in Western countries and the need of a low-risk investigation to obtain an accurate histopathological diagnosis has become increasingly pressing. Endoscopic ultrasonography (EUS) with fine-needle aspiration (FNA) is the standard method for obtaining samples from pancreatic masses. In recent years, there has been an increasing need to obtain histological specimens during EUS procedures, ra...
4 CitationsSource
#1Charing C N Chong (CUHK: The Chinese University of Hong Kong)H-Index: 19
#2Sundeep LakhtakiaH-Index: 21
Last. Anthony Yuen Bun Teoh (CUHK: The Chinese University of Hong Kong)H-Index: 32
view all 21 authors...
Background The use of macroscopic on-site evaluation (MOSE) to estimate the adequacy of a specimen for histological diagnosis during endoscopic ultrasound (EUS)-guided fine-needle tissue acquisition (FNTA) has recently been advocated. This study aimed to evaluate the diagnostic yield of MOSE compared with conventional EUS-FNTA without rapid on-site evaluation (ROSE). Methods This was an international, multicenter, prospective, randomized controlled study. After providing informed consent, consec...
7 CitationsSource
#1Andrea Lisotti (UNIBO: University of Bologna)H-Index: 17
#2Leonardo Frazzoni (UNIBO: University of Bologna)H-Index: 21
Last. Pietro Fusaroli (UNIBO: University of Bologna)H-Index: 28
view all 7 authors...
Abstract Background and Aims EUS-guided fine-needle aspiration (EUS-FNA) is the criterion standard for the diagnosis of solid pancreatic lesions. Several studies assessed the role of repeat EUS-FNA (rEUS-FNA) after an inconclusive examination. Our aim was to evaluate the pooled diagnostic accuracy of rEUS-FNA after nondiagnostic result. Methods We conducted systematic research on electronic databases (MEDLINE, PubMed, EMBASE) and meta-analysis to obtain pooled sensitivity, specificity, positive ...
11 CitationsSource
#1Se Woo Park (Sacred Heart Hospital)H-Index: 14
#2Sang Soo Lee (UOU: University of Ulsan)H-Index: 59
Last. Chan Hyuk Park (Hanyang University)H-Index: 16
view all 10 authors...
BACKGROUND AND AIM: Although several techniques for improved outcomes in endoscopic ultrasound (EUS)-guided tissue acquisition have been reported, the reported diagnostic yield for pancreatic masses is not satisfactory. The effects of novel technique (torque method) on twisting the scope in the clockwise or counterclockwise direction during EUS-fine needle biopsy (EUS-FNB) are unknown. We compared the diagnostic yield of EUS-FNB for pancreatic masses using the torque and standard techniques. MET...
9 CitationsSource
#1Dongwook Oh (UOU: University of Ulsan)H-Index: 16
#2Dong-Wan Seo (UOU: University of Ulsan)H-Index: 40
Last. Myung-Hwan Kim (UOU: University of Ulsan)H-Index: 89
view all 8 authors...
Background and Objectives: EUS-guided tissue acquisition with rapid on-site cytologic evaluation (ROSE) has been used to increase the diagnostic yield. However, ROSE is not available in many centers. To date, only a few studies have assessed the adequacy of histologic cores in macroscopic on-site evaluation (MOSE) during EUS-guided fine-needle biopsy (EUS-FNB). Blood contamination of histologic core specimens lowers the sample quality and the diagnostic yield. Therefore, we evaluated the efficac...
11 CitationsSource
#2Ermina ManfrinH-Index: 1
Last. Alberto LarghiH-Index: 30
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Abstract Background Rapid on-site evaluation (ROSE) of cytological specimensacquired with EUS-guided fine needle aspiration (EUS-FNA) represents the most accurate available technique to reach a definitive diagnosis in patients with pancreatic solid masses. Recently, needles with high histological yield have been developed for EUS-guided fine needle biopsy (EUS-FNB), with which the need for ROSE can be potentially overcome. Aims The primary aim is to compare the diagnostic accuracy of EUS-FNB wit...
12 CitationsSource
Background and aims This study aimed to evaluate the performance of Macroscopic On-site Evaluation (MOSE) using a novel endoscopic ultrasound (EUS) fine needle biopsy (FNB) needle (22-G Franseen-tip needle, Acquire, Boston Scientific Incorporated, Boston, Massachusetts, United States), and without using Rapid On-Site Evaluation (ROSE). Method Between May 2016 and August 2016, all consecutive patients referred to our center for EUS tissue acquisition (TA) for solid lesions underwent EUS-FNB with ...
21 CitationsSource
#1Tan Attila (Koç University)H-Index: 3
#2Özlem Aydin (Acıbadem University)H-Index: 13
BACKGROUND/AIMS: The aim of this study was to determine the diagnostic yield and factors influencing the diagnostic yield of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) for upper gastrointestinal (GI) subepithelial lesions (SELs) with rapid onsite cytopathologic evaluation. MATERIALS AND METHODS: This is a single-center, retrospective study. RESULTS: Among 22 patients who underwent EUS-FNA, a cytopathological diagnosis was reached in 16 (72.7%) patients. The EUS-FNA results wer...
9 CitationsSource
#1Wouter F. W. Kappelle (UU: Utrecht University)H-Index: 9
#2M. E. Van Leerdam (UU: Utrecht University)H-Index: 1
Last. Frank P. Vleggaar (UU: Utrecht University)H-Index: 56
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Studies on the impact of rapid on-site evaluation (ROSE) during endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) of lymph nodes are retrospective and have shown conflicting results. We aimed to compare the diagnostic yield of EUS-FNA of lymph nodes with ROSE (ROSE+) and without ROSE (ROSE−). This was a multicenter, randomized controlled trial. Consecutive patients who were scheduled to undergo EUS-FNA of mediastinal or abdominal lymph nodes were randomized to ROSE+ or ROSE−. In the ...
16 CitationsSource
Cited By3
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#1Benedetto Mangiavillano (Humanitas University)H-Index: 20
#2Francesco AuriemmaH-Index: 6
Last. Alessandro Repici (Humanitas University)H-Index: 71
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#1Reiko Ashida (Wakayama Medical University)H-Index: 2
#2Masayuki Kitano (Wakayama Medical University)H-Index: 40
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#1Lena Häberle (HHU: University of Düsseldorf)H-Index: 1
#2Martin Schramm (HHU: University of Düsseldorf)H-Index: 6
Last. Irene Esposito (HHU: University of Düsseldorf)H-Index: 70
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While patients with clinico-radiologically diagnosed resectable pancreatic cancer usually undergo surgery without preoperative cytological or histopathological diagnostics, patients with inoperable tumors or ambiguous findings in imaging often undergo EUS-FNA or EUS-FNB (endoscopic ultrasound-guided fine-needle aspiration or endoscopic ultrasound-guided fine-needle biopsy). In many cases, this concerns pancreatic cystic lesions, which can range from benign inflammatory pseudocysts to invasive pa...
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