Multicenter, prospective, crossover trial comparing the door-knocking method with the conventional method for EUS-FNA of solid pancreatic masses (with videos)
Background and Aims There are currently no prospective, controlled trials of needle puncture speed in EUS-guided FNA (EUS-FNA). In this study, we prospectively evaluated the accuracy of histological diagnosis and the tissue acquisition rate of EUS-FNA by using the door-knocking method (DKM) with a s...
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| Veröffentlicht in: | Gastrointestinal endoscopy 2016-06, Vol.83 (6), p.1210-1217 |
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| creator | Mukai, Shuntaro, MD Itoi, Takao, MD, FASGE Ashida, Reiko, MD Tsuchiya, Takayoshi, MD Ikeuchi, Nobuhito, MD Kamada, Kentaro, MD Tanaka, Reina, MD Umeda, Junko, MD Tonozuka, Ryosuke, MD Fukutake, Nobuyasu, MD Hoshi, Koki, MD Moriyasu, Fuminori, MD Gotoda, Takuji, MD, FASGE Irisawa, Atsushi, MD |
| description | Background and Aims There are currently no prospective, controlled trials of needle puncture speed in EUS-guided FNA (EUS-FNA). In this study, we prospectively evaluated the accuracy of histological diagnosis and the tissue acquisition rate of EUS-FNA by using the door-knocking method (DKM) with a standard 22-gauge needle. Methods From November 2013 to August 2014, 82 patients who had solid pancreatic masses underwent EUS-FNA in which the conventional method (CM) and DKM with 2 respective passes in turn were used. The primary outcomes of this study were the accuracy of histological diagnosis and the rates of tissue acquisition in 2 FNA procedures by using these 2 methods. Results Although the successful tissue acquisition rate for histology was not significantly different with the DKM and CM (91.5% vs 89.0%, P = .37), the high cellularity tissue acquisition rate for histology with the DKM was significantly superior to that with the CM (54.9% vs 41.5%, P = .03). However, adequate quality rate and accuracy were not different in the DKM and CM (78.0% vs 80.5%, P = .42 and 76.8% vs 78.0%, P = .50, respectively). In the transgastric puncture group, although the adequate quality rate and accuracy were similar in the DKM and CM (84.1% vs 79.4%, P = .30 and 84.1% vs 76.2%, P = .11, respectively), the tissue acquisition rate tended to be higher with the DKM than the CM (93.7% vs 85.7%, P = .06). Moreover, the high cellularity tissue acquisition rate was significantly better with the DKM than the CM (63.5% vs 39.7%, P = .002). On the other hand, in the transduodenal puncture group, although the tissue acquisition rate was similar with the DKM and CM (84.2% vs 100%, P = .13), the adequate quality rate and accuracy were significantly lower with the DKM than with the CM (57.9% vs 84.2%, P = .03 and 52.6% vs 84.2%, P = .02, respectively). Conclusion EUS-FNA by using a 22-gauge needle with the DKM did not improve the accuracy of histological diagnosis, but enabled acquisition of a larger amount of tissue specimen by using transgastric puncture. (Trial Registration: http://www.umin.ac.jp/english/: UMIN000012127 .) |
| doi_str_mv | 10.1016/j.gie.2015.10.025 |
| format | Article |
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In this study, we prospectively evaluated the accuracy of histological diagnosis and the tissue acquisition rate of EUS-FNA by using the door-knocking method (DKM) with a standard 22-gauge needle. Methods From November 2013 to August 2014, 82 patients who had solid pancreatic masses underwent EUS-FNA in which the conventional method (CM) and DKM with 2 respective passes in turn were used. The primary outcomes of this study were the accuracy of histological diagnosis and the rates of tissue acquisition in 2 FNA procedures by using these 2 methods. Results Although the successful tissue acquisition rate for histology was not significantly different with the DKM and CM (91.5% vs 89.0%, P = .37), the high cellularity tissue acquisition rate for histology with the DKM was significantly superior to that with the CM (54.9% vs 41.5%, P = .03). However, adequate quality rate and accuracy were not different in the DKM and CM (78.0% vs 80.5%, P = .42 and 76.8% vs 78.0%, P = .50, respectively). In the transgastric puncture group, although the adequate quality rate and accuracy were similar in the DKM and CM (84.1% vs 79.4%, P = .30 and 84.1% vs 76.2%, P = .11, respectively), the tissue acquisition rate tended to be higher with the DKM than the CM (93.7% vs 85.7%, P = .06). Moreover, the high cellularity tissue acquisition rate was significantly better with the DKM than the CM (63.5% vs 39.7%, P = .002). On the other hand, in the transduodenal puncture group, although the tissue acquisition rate was similar with the DKM and CM (84.2% vs 100%, P = .13), the adequate quality rate and accuracy were significantly lower with the DKM than with the CM (57.9% vs 84.2%, P = .03 and 52.6% vs 84.2%, P = .02, respectively). Conclusion EUS-FNA by using a 22-gauge needle with the DKM did not improve the accuracy of histological diagnosis, but enabled acquisition of a larger amount of tissue specimen by using transgastric puncture. (Trial Registration: http://www.umin.ac.jp/english/: UMIN000012127 .)</description><identifier>ISSN: 0016-5107</identifier><identifier>EISSN: 1097-6779</identifier><identifier>DOI: 10.1016/j.gie.2015.10.025</identifier><identifier>PMID: 26522372</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adenocarcinoma - diagnosis ; Adenocarcinoma - pathology ; Adult ; Aged ; Aged, 80 and over ; Autoimmune Diseases - diagnosis ; Autoimmune Diseases - pathology ; Cross-Over Studies ; Endoscopic Ultrasound-Guided Fine Needle Aspiration - methods ; Female ; Gastroenterology and Hepatology ; Humans ; Lymphoma - diagnosis ; Lymphoma - pathology ; Male ; Middle Aged ; Neuroendocrine Tumors - diagnosis ; Neuroendocrine Tumors - pathology ; Pancreatic Neoplasms - diagnosis ; Pancreatic Neoplasms - pathology ; Pancreatic Neoplasms - secondary ; Pancreatitis - diagnosis ; Pancreatitis - pathology ; Prospective Studies</subject><ispartof>Gastrointestinal endoscopy, 2016-06, Vol.83 (6), p.1210-1217</ispartof><rights>American Society for Gastrointestinal Endoscopy</rights><rights>2016 American Society for Gastrointestinal Endoscopy</rights><rights>Copyright © 2016 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c408t-5840959cba2daa1d8fe2351bc9bcfb063ab2ea08f11e405d9e76a9ec10537a2e3</citedby><cites>FETCH-LOGICAL-c408t-5840959cba2daa1d8fe2351bc9bcfb063ab2ea08f11e405d9e76a9ec10537a2e3</cites><orcidid>0000-0001-5737-620X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0016510715030412$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3536,27903,27904,65309</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26522372$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mukai, Shuntaro, MD</creatorcontrib><creatorcontrib>Itoi, Takao, MD, FASGE</creatorcontrib><creatorcontrib>Ashida, Reiko, MD</creatorcontrib><creatorcontrib>Tsuchiya, Takayoshi, MD</creatorcontrib><creatorcontrib>Ikeuchi, Nobuhito, MD</creatorcontrib><creatorcontrib>Kamada, Kentaro, MD</creatorcontrib><creatorcontrib>Tanaka, Reina, MD</creatorcontrib><creatorcontrib>Umeda, Junko, MD</creatorcontrib><creatorcontrib>Tonozuka, Ryosuke, MD</creatorcontrib><creatorcontrib>Fukutake, Nobuyasu, MD</creatorcontrib><creatorcontrib>Hoshi, Koki, MD</creatorcontrib><creatorcontrib>Moriyasu, Fuminori, MD</creatorcontrib><creatorcontrib>Gotoda, Takuji, MD, FASGE</creatorcontrib><creatorcontrib>Irisawa, Atsushi, MD</creatorcontrib><title>Multicenter, prospective, crossover trial comparing the door-knocking method with the conventional method for EUS-FNA of solid pancreatic masses (with videos)</title><title>Gastrointestinal endoscopy</title><addtitle>Gastrointest Endosc</addtitle><description>Background and Aims There are currently no prospective, controlled trials of needle puncture speed in EUS-guided FNA (EUS-FNA). In this study, we prospectively evaluated the accuracy of histological diagnosis and the tissue acquisition rate of EUS-FNA by using the door-knocking method (DKM) with a standard 22-gauge needle. Methods From November 2013 to August 2014, 82 patients who had solid pancreatic masses underwent EUS-FNA in which the conventional method (CM) and DKM with 2 respective passes in turn were used. The primary outcomes of this study were the accuracy of histological diagnosis and the rates of tissue acquisition in 2 FNA procedures by using these 2 methods. Results Although the successful tissue acquisition rate for histology was not significantly different with the DKM and CM (91.5% vs 89.0%, P = .37), the high cellularity tissue acquisition rate for histology with the DKM was significantly superior to that with the CM (54.9% vs 41.5%, P = .03). However, adequate quality rate and accuracy were not different in the DKM and CM (78.0% vs 80.5%, P = .42 and 76.8% vs 78.0%, P = .50, respectively). In the transgastric puncture group, although the adequate quality rate and accuracy were similar in the DKM and CM (84.1% vs 79.4%, P = .30 and 84.1% vs 76.2%, P = .11, respectively), the tissue acquisition rate tended to be higher with the DKM than the CM (93.7% vs 85.7%, P = .06). Moreover, the high cellularity tissue acquisition rate was significantly better with the DKM than the CM (63.5% vs 39.7%, P = .002). On the other hand, in the transduodenal puncture group, although the tissue acquisition rate was similar with the DKM and CM (84.2% vs 100%, P = .13), the adequate quality rate and accuracy were significantly lower with the DKM than with the CM (57.9% vs 84.2%, P = .03 and 52.6% vs 84.2%, P = .02, respectively). Conclusion EUS-FNA by using a 22-gauge needle with the DKM did not improve the accuracy of histological diagnosis, but enabled acquisition of a larger amount of tissue specimen by using transgastric puncture. (Trial Registration: http://www.umin.ac.jp/english/: UMIN000012127 .)</description><subject>Adenocarcinoma - diagnosis</subject><subject>Adenocarcinoma - pathology</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Autoimmune Diseases - diagnosis</subject><subject>Autoimmune Diseases - pathology</subject><subject>Cross-Over Studies</subject><subject>Endoscopic Ultrasound-Guided Fine Needle Aspiration - methods</subject><subject>Female</subject><subject>Gastroenterology and Hepatology</subject><subject>Humans</subject><subject>Lymphoma - diagnosis</subject><subject>Lymphoma - pathology</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Neuroendocrine Tumors - diagnosis</subject><subject>Neuroendocrine Tumors - pathology</subject><subject>Pancreatic Neoplasms - diagnosis</subject><subject>Pancreatic Neoplasms - pathology</subject><subject>Pancreatic Neoplasms - secondary</subject><subject>Pancreatitis - diagnosis</subject><subject>Pancreatitis - pathology</subject><subject>Prospective Studies</subject><issn>0016-5107</issn><issn>1097-6779</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9ks9u1DAQxi0EokvhAbggH4vULGMnzh8hIVVVW5AKHErPlmNPut5N4mAnQX0ZnrXO7sKBAydrZr755JnfEPKWwZoByz9s1w8W1xyYiPEauHhGVgyqIsmLonpOVhBFiWBQnJBXIWwBoOQpe0lOeC44Twu-Ir-_Tu1oNfYj-nM6eBcG1KOd8ZzqGAQ3o6ejt6ql2nWD8rZ_oOMGqXHOJ7ve6d2S6XDcOEN_2XGzr2rXz9HTuj42HouN8_Tq_i65_nZBXUODa62hg-q1RxW_QDsVAgZ6tjeZrUEX3r8mLxrVBnxzfE_J_fXVj8vPye33my-XF7eJzqAcE1FmUIlK14obpZgpG-SpYLWuat3UkKeq5qigbBjDDISpsMhVhZqBSAvFMT0lZwffuIGfE4ZRdjZobFvVo5uCZEUFWV7meRql7CDd78djIwdvO-UfJQO5YJFbGbHIBcuSilhiz7uj_VR3aP52_OEQBR8PAoxDzha9DNpir9FYH3lI4-x_7T_9061b21ut2h0-Yti6yUcOcQoZuAR5t9zFchZMQAoZ4-kTaWe1dQ</recordid><startdate>20160601</startdate><enddate>20160601</enddate><creator>Mukai, Shuntaro, MD</creator><creator>Itoi, Takao, MD, FASGE</creator><creator>Ashida, Reiko, MD</creator><creator>Tsuchiya, Takayoshi, MD</creator><creator>Ikeuchi, Nobuhito, MD</creator><creator>Kamada, Kentaro, MD</creator><creator>Tanaka, Reina, MD</creator><creator>Umeda, Junko, MD</creator><creator>Tonozuka, Ryosuke, MD</creator><creator>Fukutake, Nobuyasu, MD</creator><creator>Hoshi, Koki, MD</creator><creator>Moriyasu, Fuminori, MD</creator><creator>Gotoda, Takuji, MD, FASGE</creator><creator>Irisawa, Atsushi, MD</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-5737-620X</orcidid></search><sort><creationdate>20160601</creationdate><title>Multicenter, prospective, crossover trial comparing the door-knocking method with the conventional method for EUS-FNA of solid pancreatic masses (with videos)</title><author>Mukai, Shuntaro, MD ; Itoi, Takao, MD, FASGE ; Ashida, Reiko, MD ; Tsuchiya, Takayoshi, MD ; Ikeuchi, Nobuhito, MD ; Kamada, Kentaro, MD ; Tanaka, Reina, MD ; Umeda, Junko, MD ; Tonozuka, Ryosuke, MD ; Fukutake, Nobuyasu, MD ; Hoshi, Koki, MD ; Moriyasu, Fuminori, MD ; Gotoda, Takuji, MD, FASGE ; Irisawa, Atsushi, MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c408t-5840959cba2daa1d8fe2351bc9bcfb063ab2ea08f11e405d9e76a9ec10537a2e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adenocarcinoma - diagnosis</topic><topic>Adenocarcinoma - pathology</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Autoimmune Diseases - diagnosis</topic><topic>Autoimmune Diseases - pathology</topic><topic>Cross-Over Studies</topic><topic>Endoscopic Ultrasound-Guided Fine Needle Aspiration - methods</topic><topic>Female</topic><topic>Gastroenterology and Hepatology</topic><topic>Humans</topic><topic>Lymphoma - diagnosis</topic><topic>Lymphoma - pathology</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Neuroendocrine Tumors - diagnosis</topic><topic>Neuroendocrine Tumors - pathology</topic><topic>Pancreatic Neoplasms - diagnosis</topic><topic>Pancreatic Neoplasms - pathology</topic><topic>Pancreatic Neoplasms - secondary</topic><topic>Pancreatitis - diagnosis</topic><topic>Pancreatitis - pathology</topic><topic>Prospective Studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mukai, Shuntaro, MD</creatorcontrib><creatorcontrib>Itoi, Takao, MD, FASGE</creatorcontrib><creatorcontrib>Ashida, Reiko, MD</creatorcontrib><creatorcontrib>Tsuchiya, Takayoshi, MD</creatorcontrib><creatorcontrib>Ikeuchi, Nobuhito, MD</creatorcontrib><creatorcontrib>Kamada, Kentaro, MD</creatorcontrib><creatorcontrib>Tanaka, Reina, MD</creatorcontrib><creatorcontrib>Umeda, Junko, MD</creatorcontrib><creatorcontrib>Tonozuka, Ryosuke, MD</creatorcontrib><creatorcontrib>Fukutake, Nobuyasu, MD</creatorcontrib><creatorcontrib>Hoshi, Koki, MD</creatorcontrib><creatorcontrib>Moriyasu, Fuminori, MD</creatorcontrib><creatorcontrib>Gotoda, Takuji, MD, FASGE</creatorcontrib><creatorcontrib>Irisawa, Atsushi, MD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Gastrointestinal endoscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mukai, Shuntaro, MD</au><au>Itoi, Takao, MD, FASGE</au><au>Ashida, Reiko, MD</au><au>Tsuchiya, Takayoshi, MD</au><au>Ikeuchi, Nobuhito, MD</au><au>Kamada, Kentaro, MD</au><au>Tanaka, Reina, MD</au><au>Umeda, Junko, MD</au><au>Tonozuka, Ryosuke, MD</au><au>Fukutake, Nobuyasu, MD</au><au>Hoshi, Koki, MD</au><au>Moriyasu, Fuminori, MD</au><au>Gotoda, Takuji, MD, FASGE</au><au>Irisawa, Atsushi, MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Multicenter, prospective, crossover trial comparing the door-knocking method with the conventional method for EUS-FNA of solid pancreatic masses (with videos)</atitle><jtitle>Gastrointestinal endoscopy</jtitle><addtitle>Gastrointest Endosc</addtitle><date>2016-06-01</date><risdate>2016</risdate><volume>83</volume><issue>6</issue><spage>1210</spage><epage>1217</epage><pages>1210-1217</pages><issn>0016-5107</issn><eissn>1097-6779</eissn><abstract>Background and Aims There are currently no prospective, controlled trials of needle puncture speed in EUS-guided FNA (EUS-FNA). In this study, we prospectively evaluated the accuracy of histological diagnosis and the tissue acquisition rate of EUS-FNA by using the door-knocking method (DKM) with a standard 22-gauge needle. Methods From November 2013 to August 2014, 82 patients who had solid pancreatic masses underwent EUS-FNA in which the conventional method (CM) and DKM with 2 respective passes in turn were used. The primary outcomes of this study were the accuracy of histological diagnosis and the rates of tissue acquisition in 2 FNA procedures by using these 2 methods. Results Although the successful tissue acquisition rate for histology was not significantly different with the DKM and CM (91.5% vs 89.0%, P = .37), the high cellularity tissue acquisition rate for histology with the DKM was significantly superior to that with the CM (54.9% vs 41.5%, P = .03). However, adequate quality rate and accuracy were not different in the DKM and CM (78.0% vs 80.5%, P = .42 and 76.8% vs 78.0%, P = .50, respectively). In the transgastric puncture group, although the adequate quality rate and accuracy were similar in the DKM and CM (84.1% vs 79.4%, P = .30 and 84.1% vs 76.2%, P = .11, respectively), the tissue acquisition rate tended to be higher with the DKM than the CM (93.7% vs 85.7%, P = .06). Moreover, the high cellularity tissue acquisition rate was significantly better with the DKM than the CM (63.5% vs 39.7%, P = .002). On the other hand, in the transduodenal puncture group, although the tissue acquisition rate was similar with the DKM and CM (84.2% vs 100%, P = .13), the adequate quality rate and accuracy were significantly lower with the DKM than with the CM (57.9% vs 84.2%, P = .03 and 52.6% vs 84.2%, P = .02, respectively). Conclusion EUS-FNA by using a 22-gauge needle with the DKM did not improve the accuracy of histological diagnosis, but enabled acquisition of a larger amount of tissue specimen by using transgastric puncture. (Trial Registration: http://www.umin.ac.jp/english/: UMIN000012127 .)</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>26522372</pmid><doi>10.1016/j.gie.2015.10.025</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0001-5737-620X</orcidid></addata></record> |
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| subjects | Adenocarcinoma - diagnosis Adenocarcinoma - pathology Adult Aged Aged, 80 and over Autoimmune Diseases - diagnosis Autoimmune Diseases - pathology Cross-Over Studies Endoscopic Ultrasound-Guided Fine Needle Aspiration - methods Female Gastroenterology and Hepatology Humans Lymphoma - diagnosis Lymphoma - pathology Male Middle Aged Neuroendocrine Tumors - diagnosis Neuroendocrine Tumors - pathology Pancreatic Neoplasms - diagnosis Pancreatic Neoplasms - pathology Pancreatic Neoplasms - secondary Pancreatitis - diagnosis Pancreatitis - pathology Prospective Studies |
| title | Multicenter, prospective, crossover trial comparing the door-knocking method with the conventional method for EUS-FNA of solid pancreatic masses (with videos) |
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