Comparison of contrast-enhanced versus conventional EUS-guided FNA/fine-needle biopsy in diagnosis of solid pancreatic lesions: a randomized controlled trial
- Authors
- Cho, In Rae; Jeong, Seok-Hoo; Kang, Huapyong; Kim, Eui Joo; Kim, Yeon Suk; Cho, Jae Hee
- Issue Date
- Aug-2021
- Publisher
- MOSBY-ELSEVIER
- Citation
- Gastrointestinal Endoscopy, v.94, no.2, pp.303 - 310
- Journal Title
- Gastrointestinal Endoscopy
- Volume
- 94
- Number
- 2
- Start Page
- 303
- End Page
- 310
- URI
- https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/81742
- DOI
- 10.1016/j.gie.2021.01.018
- ISSN
- 0016-5107
- Abstract
- Background and Aims: Contrast-enhanced harmonic EUS (CEH-EUS) is useful in the differential diagnosis of solid pancreatic lesions (SPLs). However, there is lack of verification about the usefulness of CEH-EUS–guided FNA/fine-needle biopsy (FNB) sampling. This study aimed to investigate the usefulness of CEH-EUS–guided FNA/FNB sampling without on-site cytopathology. Methods: Patients with SPLs were prospectively enrolled and randomly assigned (1:1) to 2 parallel groups, the interventional group (CEH-EUS) or the control group (conventional EUS). The diagnostic sensitivity and optimal number of needle passes for pathologic diagnosis were investigated and compared between groups. Results: Two hundred forty patients were enrolled from March 2016 to September 2019, with 120 patients assigned to each group. Pancreatic malignancies and neuroendocrine tumors were found in 202 (90.83%) and 9 (3.75%) patients, respectively. There was no statistically significant difference between the groups in terms of age, sex, lesion size (30.96 ± 12.09 mm in the CEH-EUS group vs 33.09 ± 16.39 mm in the conventional EUS group; P = .252), lesion location, adverse event rate, and disease distribution. The diagnostic sensitivity values in the CEH-EUS and conventional EUS groups were 85.8% and 88.3%, respectively (P = .564). All patients in the conventional EUS group and most in the CEH-EUS group received a pathologic diagnosis within 3 needle passes. Conclusions: Diagnostic sensitivity for SPLs was not different between the CEH-EUS and conventional EUS groups, and no independent factors were found that could improve diagnostic sensitivity. CEH-EUS–guided FNA/FNB sampling does not need to be used routinely and may be selectively considered for small, indeterminate lesions. (Clinical trial registration number: KCT 0001840.) © 2021 American Society for Gastrointestinal Endoscopy
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