Endoscopic ultrasound‐guided fine‐needle aspiration biopsy: A powerful tool to obtain samples from small lesions

BACKGROUND Endoscopic ultrasound (EUS) is a powerful imaging modality to identify and determine the extent of a lesion. In addition, EUS is superior to a computed tomography scan in detecting lesions < 3 cm. The objective of the current study was to determine whether small lesions (≤ 25 mm) affected the specimen adequacy and the diagnostic accuracy for lesions aspirated under EUS guidance. METHODS In the current study, 209 consecutive EUS‐guided fine‐needle aspiration biopsy (EUS‐FNAB) samples ≤ 25 mm (100 samples) or > 25 mm (109 samples) as determined by EUS were obtained from 151 patients with a mean age of 62 years (range, 39–94 years). A cytopathologist present in the endoscopy suite determined specimen adequacy. Yield of adequate samples for diagnosis, number of passes, and operating characteristics of EUS‐FNAB for small (≤ 25 mm) and large lesions (>25 mm) were compared. RESULTS The overall yield of obtaining adequate samples for diagnosis was 96% (201 of 209). There was no difference noted with regard to the yield of obtaining samples (96% vs. 96%) from small or large lesions. A mean of 2.5 passes (range, 1–9 passes) was needed to obtain adequate samples from lesions ≤ 25 mm, whereas a mean of 4.5 passes (range, 1–11 passes) was needed to obtain adequate samples from lesions > 25 mm. The sensitivity (96% vs. 96%), specificity (100% vs. 100%), and diagnostic accuracy (98% vs. 97%) for EUS‐FNAB were comparable whether the lesion was ≤ 25 mm or > 25 mm. CONCLUSIONS EUS‐FNAB was a highly effective technique to obtain samples from small (≤ 25 mm) and large (> 25 mm) lesions without affecting the sensitivity, specificity, or diagnostic accuracy. Cancer (Cancer Cytopathol) 2004. © 2004 American Cancer Society. Cancer (Cancer Cytopathol) 2004. © 2004 American Cancer Society. The current article showed that endoscopic ultrasound‐guided fine‐needle aspiration biopsy (EUS‐FNAB) is a powerful modality with which to obtain samples from small (≤ 25 mm) and large lesions with no difference in yield of samples (96 % vs. 96%) from the two groups. Most of the adequate samples for diagnosis of small lesions can be obtained within five passes irrespective of the organ site. The overall sensitivity (96% vs. 96%), specificity (100% vs. 100%), positive predictive value (100% vs. 100%), negative predictive value (96% vs. 91%), and diagnostic accuracy (98% vs. 97%) remained comparable regardless of whether the lesion was small or large. The results showed that EUS‐FNAB is