Endoscopic ultrasound-guided fine needle aspiration with 22- and 25-gauge needles in solid pancreatic masses: A prospective comparative study with randomisation of needle sequence

Abstract Background The difference in the diagnostic accuracy of 22- versus 25-gauge needles in EUS-FNA is not clear. Aims To compare the rates of technical success, diagnostic accuracy and complications of EUS-FNA performed with 22-gauge and 25-gauge needles on the same solid pancreatic mass. Metho...

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Bibliographic Details
Published in:Digestive and liver disease 2011-08, Vol.43 (8), p.647-652
Main Authors: Fabbri, Carlo, Polifemo, Anna Maria, Luigiano, Carmelo, Cennamo, Vincenzo, Baccarini, Paola, Collina, Guido, Fornelli, Adele, Macchia, Sandro, Zanini, Nicola, Jovine, Elio, Fiscaletti, Marta, Alibrandi, Angela, D’Imperio, Nicola
Format: Article
Language:English
Subjects:
22-Gauge needle
25-Gauge needle
Aged
Aged, 80 and over
Biopsy, Fine-Needle - instrumentation
EUS-FNA
Female
Gastroenterology and Hepatology
Humans
Male
Middle Aged
Pancreatic cytology
Pancreatic mass
Pancreatic Neoplasms - pathology
Predictive Value of Tests
Prospective Studies
Reproducibility of Results
Ultrasonography, Interventional
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Summary:Abstract Background The difference in the diagnostic accuracy of 22- versus 25-gauge needles in EUS-FNA is not clear. Aims To compare the rates of technical success, diagnostic accuracy and complications of EUS-FNA performed with 22-gauge and 25-gauge needles on the same solid pancreatic mass. Methods All patients with solid pancreatic masses evaluated from September 2007 to December 2008 were enrolled and underwent EUS-FNA with both 22- and 25-gauge needles with randomisation of needle sequence. The accuracy of the EUS-FNA was determined by comparing the cytological results with the final surgical pathological diagnoses or with the results of a clinical follow-up. A cytological score with different qualitative parameters was created, and a comparison between these parameters was carried out for each needle. Results Fifty patients with 50 pancreatic masses were recruited. Technical success was 100% and no complications occurred. Diagnostic accuracy was 94% and 86% for the 25- and 22-gauge needles, respectively. Analysis of the cytological score showed a tendency towards the 25-gauge needle, although the difference was not statistically significant. Conclusions EUS-FNA performed with 22- or 25-gauge needles had the same diagnostic accuracy. Our study results confirm a significant trend towards a better cytological diagnosis for the 25-gauge needle.
ISSN:1590-8658
1878-3562
DOI:10.1016/j.dld.2011.04.005