Factors Affecting the Learning Curve in the Endoscopic Ultrasound-Guided Sampling of Solid Pancreatic Lesions: A Prospective Study
Background/Aims: Endosonography is associated with a long learning curve. We aimed to assess variables that may influence the diagnostic outcomes in endoscopic ultrasound-guided fine-needle aspiration/biopsy (EUS-FNA/B) of solid pancreatic tumors regarding the level of endoscopists' experience....
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| Veröffentlicht in: | Gut and liver 2023-03, Vol.17 (2), p.308 |
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| creator | Marcel Razpotnik Simona Bota Mathilde Kutilek Gerolf Essler Christian Urak Julian Prosenz Jutta Weber-eibel Andreas Maieron Markus Peck-radosavljevic |
| description | Background/Aims: Endosonography is associated with a long learning curve. We aimed to assess variables that may influence the diagnostic outcomes in endoscopic ultrasound-guided fine-needle aspiration/biopsy (EUS-FNA/B) of solid pancreatic tumors regarding the level of endoscopists' experience.
Methods: Consecutive patients undergoing EUS-guided puncture of solid pancreatic tumors (eight endosonographers, including six trainees) were prospectively enrolled. An experienced endosonographer was defined as having performed at least 250 EUS examinations, including 75 FNA/Bs. The final diagnosis was determined by cytopathology, histopathology, or clinical followup.
Results: In total, 283 EUS-FNA/Bs of solid pancreatic tumors (75.6% malignant) in 239 patients (median age 69 years, 57.6% males) were enrolled. Trainees performed 149/283 (52.7%) of the interventions. Accuracy and sensitivity for detecting malignancy were significantly higher in the expert group than in the trainee group (85.8% vs 73.2%, p=0.01 and 82.5% vs 68.4%, p=0.02). Solid lesions evaluated by an expert using FNB needles showed the best odds for a correct diagnosis (odds ratio, 3.07; 95% confidence interval, 1.15 to 8.23; p=0.02). More experienced endoscopists achieved better accuracy in sampling via the transduodenal approach (86.7% vs 68.5%, p |
| format | Article |
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Methods: Consecutive patients undergoing EUS-guided puncture of solid pancreatic tumors (eight endosonographers, including six trainees) were prospectively enrolled. An experienced endosonographer was defined as having performed at least 250 EUS examinations, including 75 FNA/Bs. The final diagnosis was determined by cytopathology, histopathology, or clinical followup.
Results: In total, 283 EUS-FNA/Bs of solid pancreatic tumors (75.6% malignant) in 239 patients (median age 69 years, 57.6% males) were enrolled. Trainees performed 149/283 (52.7%) of the interventions. Accuracy and sensitivity for detecting malignancy were significantly higher in the expert group than in the trainee group (85.8% vs 73.2%, p=0.01 and 82.5% vs 68.4%, p=0.02). Solid lesions evaluated by an expert using FNB needles showed the best odds for a correct diagnosis (odds ratio, 3.07; 95% confidence interval, 1.15 to 8.23; p=0.02). More experienced endoscopists achieved better accuracy in sampling via the transduodenal approach (86.7% vs 68.5%, p<0.001), in the sampling of malignant lesions (82.5 vs 68.4, p=0.02), and in the sampling of lesions located in the pancreatic head (86.1 vs 69.1, p=0.02). In cases involving these factors, we observed a moderate improvement in the diagnostic accuracy after 40 attempts.
Conclusions: Transduodenal approach, pancreatic head lesions, and malignancy were recognized as the most important clinical factors affecting the learning curve in EUS-FNA/B of solid pancreatic lesions. (Gut Liver 2023;17:308-317)</description><identifier>ISSN: 1976-2283</identifier><language>kor</language><publisher>대한소화기학회</publisher><subject>biopsy ; Competence ; Endosonography ; Fine-needle aspiration ; Learning ; Pancreatic tumor</subject><ispartof>Gut and liver, 2023-03, Vol.17 (2), p.308</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784</link.rule.ids></links><search><creatorcontrib>Marcel Razpotnik</creatorcontrib><creatorcontrib>Simona Bota</creatorcontrib><creatorcontrib>Mathilde Kutilek</creatorcontrib><creatorcontrib>Gerolf Essler</creatorcontrib><creatorcontrib>Christian Urak</creatorcontrib><creatorcontrib>Julian Prosenz</creatorcontrib><creatorcontrib>Jutta Weber-eibel</creatorcontrib><creatorcontrib>Andreas Maieron</creatorcontrib><creatorcontrib>Markus Peck-radosavljevic</creatorcontrib><title>Factors Affecting the Learning Curve in the Endoscopic Ultrasound-Guided Sampling of Solid Pancreatic Lesions: A Prospective Study</title><title>Gut and liver</title><addtitle>Gut and Liver</addtitle><description>Background/Aims: Endosonography is associated with a long learning curve. We aimed to assess variables that may influence the diagnostic outcomes in endoscopic ultrasound-guided fine-needle aspiration/biopsy (EUS-FNA/B) of solid pancreatic tumors regarding the level of endoscopists' experience.
Methods: Consecutive patients undergoing EUS-guided puncture of solid pancreatic tumors (eight endosonographers, including six trainees) were prospectively enrolled. An experienced endosonographer was defined as having performed at least 250 EUS examinations, including 75 FNA/Bs. The final diagnosis was determined by cytopathology, histopathology, or clinical followup.
Results: In total, 283 EUS-FNA/Bs of solid pancreatic tumors (75.6% malignant) in 239 patients (median age 69 years, 57.6% males) were enrolled. Trainees performed 149/283 (52.7%) of the interventions. Accuracy and sensitivity for detecting malignancy were significantly higher in the expert group than in the trainee group (85.8% vs 73.2%, p=0.01 and 82.5% vs 68.4%, p=0.02). Solid lesions evaluated by an expert using FNB needles showed the best odds for a correct diagnosis (odds ratio, 3.07; 95% confidence interval, 1.15 to 8.23; p=0.02). More experienced endoscopists achieved better accuracy in sampling via the transduodenal approach (86.7% vs 68.5%, p<0.001), in the sampling of malignant lesions (82.5 vs 68.4, p=0.02), and in the sampling of lesions located in the pancreatic head (86.1 vs 69.1, p=0.02). In cases involving these factors, we observed a moderate improvement in the diagnostic accuracy after 40 attempts.
Conclusions: Transduodenal approach, pancreatic head lesions, and malignancy were recognized as the most important clinical factors affecting the learning curve in EUS-FNA/B of solid pancreatic lesions. (Gut Liver 2023;17:308-317)</description><subject>biopsy</subject><subject>Competence</subject><subject>Endosonography</subject><subject>Fine-needle aspiration</subject><subject>Learning</subject><subject>Pancreatic tumor</subject><issn>1976-2283</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><recordid>eNp9TbsOgjAU7aCJ-PgCl_sDJIAK6kYI6OBggs6kaYtWoSW9xYTVLxeMs9PJeY-I4--i0A2C7WpCpogPzwv9INo45J1RZrVBiMtSMCvVDexdwElQowaStOYlQKqvmiqukelGMrhW1lDUreLuoZVccMhp3VRDRZeQ60pyOFPFjKC2j58ESq1wDzGcjcZmuOp3c9vybk7GJa1QLH44I8ssvSRH9ykRi8bImpquWHte5K-D1X_3A_EgSrA</recordid><startdate>20230330</startdate><enddate>20230330</enddate><creator>Marcel Razpotnik</creator><creator>Simona Bota</creator><creator>Mathilde Kutilek</creator><creator>Gerolf Essler</creator><creator>Christian Urak</creator><creator>Julian Prosenz</creator><creator>Jutta Weber-eibel</creator><creator>Andreas Maieron</creator><creator>Markus Peck-radosavljevic</creator><general>대한소화기학회</general><scope>HZB</scope><scope>Q5X</scope></search><sort><creationdate>20230330</creationdate><title>Factors Affecting the Learning Curve in the Endoscopic Ultrasound-Guided Sampling of Solid Pancreatic Lesions: A Prospective Study</title><author>Marcel Razpotnik ; Simona Bota ; Mathilde Kutilek ; Gerolf Essler ; Christian Urak ; Julian Prosenz ; Jutta Weber-eibel ; Andreas Maieron ; Markus Peck-radosavljevic</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-kiss_primary_40071423</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>kor</language><creationdate>2023</creationdate><topic>biopsy</topic><topic>Competence</topic><topic>Endosonography</topic><topic>Fine-needle aspiration</topic><topic>Learning</topic><topic>Pancreatic tumor</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Marcel Razpotnik</creatorcontrib><creatorcontrib>Simona Bota</creatorcontrib><creatorcontrib>Mathilde Kutilek</creatorcontrib><creatorcontrib>Gerolf Essler</creatorcontrib><creatorcontrib>Christian Urak</creatorcontrib><creatorcontrib>Julian Prosenz</creatorcontrib><creatorcontrib>Jutta Weber-eibel</creatorcontrib><creatorcontrib>Andreas Maieron</creatorcontrib><creatorcontrib>Markus Peck-radosavljevic</creatorcontrib><collection>Korean Studies Information Service System (KISS)</collection><collection>Korean Studies Information Service System (KISS) B-Type</collection><jtitle>Gut and liver</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Marcel Razpotnik</au><au>Simona Bota</au><au>Mathilde Kutilek</au><au>Gerolf Essler</au><au>Christian Urak</au><au>Julian Prosenz</au><au>Jutta Weber-eibel</au><au>Andreas Maieron</au><au>Markus Peck-radosavljevic</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Factors Affecting the Learning Curve in the Endoscopic Ultrasound-Guided Sampling of Solid Pancreatic Lesions: A Prospective Study</atitle><jtitle>Gut and liver</jtitle><addtitle>Gut and Liver</addtitle><date>2023-03-30</date><risdate>2023</risdate><volume>17</volume><issue>2</issue><spage>308</spage><pages>308-</pages><issn>1976-2283</issn><abstract>Background/Aims: Endosonography is associated with a long learning curve. We aimed to assess variables that may influence the diagnostic outcomes in endoscopic ultrasound-guided fine-needle aspiration/biopsy (EUS-FNA/B) of solid pancreatic tumors regarding the level of endoscopists' experience.
Methods: Consecutive patients undergoing EUS-guided puncture of solid pancreatic tumors (eight endosonographers, including six trainees) were prospectively enrolled. An experienced endosonographer was defined as having performed at least 250 EUS examinations, including 75 FNA/Bs. The final diagnosis was determined by cytopathology, histopathology, or clinical followup.
Results: In total, 283 EUS-FNA/Bs of solid pancreatic tumors (75.6% malignant) in 239 patients (median age 69 years, 57.6% males) were enrolled. Trainees performed 149/283 (52.7%) of the interventions. Accuracy and sensitivity for detecting malignancy were significantly higher in the expert group than in the trainee group (85.8% vs 73.2%, p=0.01 and 82.5% vs 68.4%, p=0.02). Solid lesions evaluated by an expert using FNB needles showed the best odds for a correct diagnosis (odds ratio, 3.07; 95% confidence interval, 1.15 to 8.23; p=0.02). More experienced endoscopists achieved better accuracy in sampling via the transduodenal approach (86.7% vs 68.5%, p<0.001), in the sampling of malignant lesions (82.5 vs 68.4, p=0.02), and in the sampling of lesions located in the pancreatic head (86.1 vs 69.1, p=0.02). In cases involving these factors, we observed a moderate improvement in the diagnostic accuracy after 40 attempts.
Conclusions: Transduodenal approach, pancreatic head lesions, and malignancy were recognized as the most important clinical factors affecting the learning curve in EUS-FNA/B of solid pancreatic lesions. (Gut Liver 2023;17:308-317)</abstract><pub>대한소화기학회</pub><tpages>10</tpages></addata></record> |
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| identifier | ISSN: 1976-2283 |
| ispartof | Gut and liver, 2023-03, Vol.17 (2), p.308 |
| issn | 1976-2283 |
| language | kor |
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| source | DOAJ Directory of Open Access Journals; KoreaMed Open Access; EZB-FREE-00999 freely available EZB journals; PubMed Central |
| subjects | biopsy Competence Endosonography Fine-needle aspiration Learning Pancreatic tumor |
| title | Factors Affecting the Learning Curve in the Endoscopic Ultrasound-Guided Sampling of Solid Pancreatic Lesions: A Prospective Study |
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