DOI: 10.1097/eus.0000000000000052 ISSN: 2226-7190

Diagnostic performance of EUS-guided tissue acquisition for solid pancreatic lesions ≤10 mm

Yuki Kawasaki, Susumu Hijioka, Yoshikuni Nagashio, Akihiro Ohba, Yuta Maruki, Kotaro Takeshita, Tetsuro Takasaki, Daiki Agarie, Yuya Hagiwara, Hidenobu Hara, Kohei Okamoto, Daiki Yamashige, Shunsuke Kondo, Chigusa Morizane, Hideki Ueno, Takahiro Mizui, Takeshi Takamoto, Satoshi Nara, Daisuke Ban, Minoru Esaki, Yutaka Saito, Nobuyoshi Hiraoka, Takuji Okusaka
  • Gastroenterology
  • Radiology, Nuclear Medicine and imaging
  • Hepatology
  • Gastroenterology
  • Radiology, Nuclear Medicine and imaging
  • Hepatology

ABSTRACT

Background and Objectives

EUS tissue acquisition (EUS-TA) is the standard diagnostic method for solid pancreatic lesions (SPLs); however, there are few reports on EUS-TA results for SPLs ≤10 mm. Furthermore, given the recent advent of fine-needle biopsy, the current diagnostic accuracy of EUS-TA for SPLs ≤10 mm is unknown. This study aimed to evaluate the diagnostic accuracy and efficacy of EUS-TA for SPLs ≤10 mm.

Methods

We retrospectively analyzed the data of 109 patients with SPLs ≤10 mm who underwent EUS-TA. All patients underwent rapid on-site specimen evaluation.

Results

The median tumor diameter was 8 mm (range, 2.5–10 mm), and the technical success rate was 99.1% (108/109). Adverse events were observed in 3 patients (2.8%). The diagnostic performance was as follows: sensitivity, 90.1% (64/71); specificity, 97.3% (36/37); accuracy, 92.6% (100/108); positive predictive value, 98.5% (64/65); and negative predictive value, 83.7% (36/43). Multivariate analysis revealed that the number of punctures (odds ratio, 7.03; 95% confidence interval, 1.32–37.5; P = 0.023) and tumor type (odds ratio, 11.90; 95% confidence interval, 1.38–102.0; P = 0.024) were independent risk factors for inaccurate EUS-TA results. The diagnostic accuracy of EUS-TA for pancreatic ductal adenocarcinoma was 87.5% (14/16). No EUS-TA–related needle-tract seeding was observed in patients with pancreatic ductal adenocarcinoma during the observation period.

Conclusions

EUS-TA for SPLs ≤10 mm showed adequate diagnostic accuracy and was safe for use with rapid on-site specimen evaluation in all cases.

More from our Archive