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The role of rapid on‐site evaluation on diagnostic accuracy of endoscopic ultrasound fine needle aspiration for pancreatic, submucosal upper gastrointestinal tract and adjacent lesions
Author(s) -
Khoury Tawfik,
Kadah Anas,
Farraj Moaad,
Barhoum Masaad,
Livoff Alejandro,
Mari Amir,
Mahamid Mahmud,
Sbeit Wisam
Publication year - 2019
Publication title -
cytopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.512
H-Index - 48
eISSN - 1365-2303
pISSN - 0956-5507
DOI - 10.1111/cyt.12712
Subject(s) - medicine , endoscopic ultrasound , fine needle aspiration , diagnostic accuracy , radiology , pancreas , retrospective cohort study , lesion , gastrointestinal tract , stage (stratigraphy) , surgery , biopsy , paleontology , biology
Background and Aim Our aim was to assess adequacy and diagnostic accuracy of endoscopic ultrasound‐fine needle aspiration ( EUS ‐ FNA ) specimens with or without rapid on‐site evaluation ( ROSE ) from pancreatic, upper gastrointestinal tract ( UGIT ) and adjacent masses. Method A retrospective cohort study based on patients’ files who underwent EUS ‐ FNA in Galilee Medical Center in a 4 years period. Number of needle passes, repeated EUS and ROSE effect on tissue adequacy and diagnostic accuracy were reported. Results One‐hundred sixty‐one patients were included. Ninety‐three patients (57.7%) underwent EUS ‐ FNA without ROSE (group A) compared to 68 patients (42.3%) with ROSE (group B). The most common location was in the pancreas (55% in group A vs 81% in group B). Addition of ROSE yielded a significantly higher specimen adequacy (65% in group A vs 92.6% in group B (Chi‐Square < 0.0001, OR 6.72, 95% CI 2.45‐18.38). The matching rate (accuracy) between ROSE diagnosis and final histopathological diagnosis was noticed in 61 out of 68 patients (89.7%, 95% CI 0.7993‐0.9576). The Kappa coefficient correlations of matching rate between ROSE and final histopathological diagnosis of all lesion and in pancreatic lesions were 0.7558, (95% CI 0.625‐0.887) and 0.7814, (95% CI 0.639‐0.924), respectively. Conclusions EUS ‐ FNA with ROSE significantly improve specimen adequacy and was associated with high diagnostic accuracy.