Slow-pull using a fanning technique is more useful than the standard suction technique in EUS-guided fine needle aspiration in pancreatic masses

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Abstract

Background/Aims: Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is useful for obtaining pancreatic mass samples. The combination of modified techniques (i.e., slow-pull technique and fanning technique) may improve the quality of the sample obtained by EUS-FNA. We investigated the effectiveness of a combined slow-pull fanning technique in EUS-FNA for pancreatic mass. Methods: This prospective comparative study investigated EUS-FNA performed for pancreatic solid masses between August 2015 and July 2016. Pairwise specimens were alternately obtained using the following two techniques for targeted pancreatic lesions: standard suction or slow-pull with fanning. We compared the specimen quality, blood contamination, and diagnostic accuracy of these techniques. Results: Forty-eight consecutive patients were included (29 men; mean age, 68.1±11.9 years), and 96 pancreatic mass specimens were obtained. The slow-pull with fanning technique had a significantly superior diagnostic accuracy than the suction technique (88% vs 71%, p=0.044). Furthermore, blood contamination was significantly reduced using the slow-pull with fanning technique (ratio of no or slight contamination, 77% vs 56%, p=0.041). No difference was observed in the acquisition of adequate cellularity between the groups. In the subgroup analysis, the tumor size and sampling technique were related to the EUSFNA diagnostic accuracy. Conclusions: The slow-pull with needle fanning technique showed a good diagnostic yield for EUS-FNA for pancreatic mass. This technique can be useful for performing EUS-guided sampling for diagnosing pancreatic disease.

Original languageEnglish
Pages (from-to)360-366
Number of pages7
JournalGut and Liver
Volume12
Issue number3
DOIs
Publication statusPublished - 2018 May 1

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Endoscopic Ultrasound-Guided Fine Needle Aspiration
Suction
Fine Needle Biopsy
Pancreatic Diseases
Needles
Prospective Studies
Neoplasms

Keywords

  • Biopsy
  • Endosonography
  • Fine-needle
  • Pancreas

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

Cite this

@article{313aa3d4d00948a0875a679b33f6ed35,
title = "Slow-pull using a fanning technique is more useful than the standard suction technique in EUS-guided fine needle aspiration in pancreatic masses",
abstract = "Background/Aims: Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is useful for obtaining pancreatic mass samples. The combination of modified techniques (i.e., slow-pull technique and fanning technique) may improve the quality of the sample obtained by EUS-FNA. We investigated the effectiveness of a combined slow-pull fanning technique in EUS-FNA for pancreatic mass. Methods: This prospective comparative study investigated EUS-FNA performed for pancreatic solid masses between August 2015 and July 2016. Pairwise specimens were alternately obtained using the following two techniques for targeted pancreatic lesions: standard suction or slow-pull with fanning. We compared the specimen quality, blood contamination, and diagnostic accuracy of these techniques. Results: Forty-eight consecutive patients were included (29 men; mean age, 68.1±11.9 years), and 96 pancreatic mass specimens were obtained. The slow-pull with fanning technique had a significantly superior diagnostic accuracy than the suction technique (88{\%} vs 71{\%}, p=0.044). Furthermore, blood contamination was significantly reduced using the slow-pull with fanning technique (ratio of no or slight contamination, 77{\%} vs 56{\%}, p=0.041). No difference was observed in the acquisition of adequate cellularity between the groups. In the subgroup analysis, the tumor size and sampling technique were related to the EUSFNA diagnostic accuracy. Conclusions: The slow-pull with needle fanning technique showed a good diagnostic yield for EUS-FNA for pancreatic mass. This technique can be useful for performing EUS-guided sampling for diagnosing pancreatic disease.",
keywords = "Biopsy, Endosonography, Fine-needle, Pancreas",
author = "Lee, {Jae Min} and Lee, {Hong Sik} and Hyun, {Jong Jin} and Lee, {Jung Min} and Yoo, {In Kyung} and Kim, {Seung Han} and Choi, {Hyuk Soon} and Eun-Sun Kim and Bora Keum and Seo, {Yeon Seok} and Jeen, {Yoon Tae} and Hoon-Jai Chun and Soon-Ho Um and Kim, {Chang Duck}",
year = "2018",
month = "5",
day = "1",
doi = "10.5009/gnl17140",
language = "English",
volume = "12",
pages = "360--366",
journal = "Gut and Liver",
issn = "1976-2283",
publisher = "Joe Bok Chung",
number = "3",

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TY - JOUR

T1 - Slow-pull using a fanning technique is more useful than the standard suction technique in EUS-guided fine needle aspiration in pancreatic masses

AU - Lee, Jae Min

AU - Lee, Hong Sik

AU - Hyun, Jong Jin

AU - Lee, Jung Min

AU - Yoo, In Kyung

AU - Kim, Seung Han

AU - Choi, Hyuk Soon

AU - Kim, Eun-Sun

AU - Keum, Bora

AU - Seo, Yeon Seok

AU - Jeen, Yoon Tae

AU - Chun, Hoon-Jai

AU - Um, Soon-Ho

AU - Kim, Chang Duck

PY - 2018/5/1

Y1 - 2018/5/1

N2 - Background/Aims: Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is useful for obtaining pancreatic mass samples. The combination of modified techniques (i.e., slow-pull technique and fanning technique) may improve the quality of the sample obtained by EUS-FNA. We investigated the effectiveness of a combined slow-pull fanning technique in EUS-FNA for pancreatic mass. Methods: This prospective comparative study investigated EUS-FNA performed for pancreatic solid masses between August 2015 and July 2016. Pairwise specimens were alternately obtained using the following two techniques for targeted pancreatic lesions: standard suction or slow-pull with fanning. We compared the specimen quality, blood contamination, and diagnostic accuracy of these techniques. Results: Forty-eight consecutive patients were included (29 men; mean age, 68.1±11.9 years), and 96 pancreatic mass specimens were obtained. The slow-pull with fanning technique had a significantly superior diagnostic accuracy than the suction technique (88% vs 71%, p=0.044). Furthermore, blood contamination was significantly reduced using the slow-pull with fanning technique (ratio of no or slight contamination, 77% vs 56%, p=0.041). No difference was observed in the acquisition of adequate cellularity between the groups. In the subgroup analysis, the tumor size and sampling technique were related to the EUSFNA diagnostic accuracy. Conclusions: The slow-pull with needle fanning technique showed a good diagnostic yield for EUS-FNA for pancreatic mass. This technique can be useful for performing EUS-guided sampling for diagnosing pancreatic disease.

AB - Background/Aims: Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is useful for obtaining pancreatic mass samples. The combination of modified techniques (i.e., slow-pull technique and fanning technique) may improve the quality of the sample obtained by EUS-FNA. We investigated the effectiveness of a combined slow-pull fanning technique in EUS-FNA for pancreatic mass. Methods: This prospective comparative study investigated EUS-FNA performed for pancreatic solid masses between August 2015 and July 2016. Pairwise specimens were alternately obtained using the following two techniques for targeted pancreatic lesions: standard suction or slow-pull with fanning. We compared the specimen quality, blood contamination, and diagnostic accuracy of these techniques. Results: Forty-eight consecutive patients were included (29 men; mean age, 68.1±11.9 years), and 96 pancreatic mass specimens were obtained. The slow-pull with fanning technique had a significantly superior diagnostic accuracy than the suction technique (88% vs 71%, p=0.044). Furthermore, blood contamination was significantly reduced using the slow-pull with fanning technique (ratio of no or slight contamination, 77% vs 56%, p=0.041). No difference was observed in the acquisition of adequate cellularity between the groups. In the subgroup analysis, the tumor size and sampling technique were related to the EUSFNA diagnostic accuracy. Conclusions: The slow-pull with needle fanning technique showed a good diagnostic yield for EUS-FNA for pancreatic mass. This technique can be useful for performing EUS-guided sampling for diagnosing pancreatic disease.

KW - Biopsy

KW - Endosonography

KW - Fine-needle

KW - Pancreas

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U2 - 10.5009/gnl17140

DO - 10.5009/gnl17140

M3 - Article

VL - 12

SP - 360

EP - 366

JO - Gut and Liver

JF - Gut and Liver

SN - 1976-2283

IS - 3

ER -