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Agreement on endoscopic ultrasonography‐guided tissue specimens: Comparing a 20‐G fine‐needle biopsy to a 25‐G fine‐needle aspiration needle among academic and non‐academic pathologists
Author(s) -
Riet Priscilla A.,
Cahen Djuna L.,
Biermann Katharina,
Hansen Bettina,
Larghi Alberto,
Rindi Guido,
Fellegara Giovanni,
Arcidiacono Paolo,
Doglioni Claudio,
Liberta Decarli Nicola,
IglesiasGarcia Julio,
Abdulkader Ihab,
Lazare Iglesias Hector,
Kitano Masayuki,
Chikugo Takaaki,
Yasukawa Satoru,
Valk Hans,
Nguyen Nam Quoc,
Ruszkiewicz Andrew,
Giovannini Marc,
Poizat Flora,
Merwe Schalk,
Roskams Tania,
Santo Erwin,
Marmor Silvia,
Chang Kenneth,
Lin Fritz,
Farrell James,
Robert Marie,
Bucobo Juan Carlos,
Heimann Alan,
BaldaqueSilva Francisco,
Fernández Moro Carlos,
Bruno Marco J.
Publication year - 2019
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/den.13424
Subject(s) - medicine , fine needle aspiration , fine needle biopsy , biopsy , radiology , lymph node , malignancy , cytology , cytopathology , histology , pathology
Background and Aim A recently carried out randomized controlled trial showed the benefit of a novel 20‐G fine‐needle biopsy ( FNB ) over a 25‐G fine‐needle aspiration ( FNA ) needle. The current study evaluated the reproducibility of these findings among expert academic and non‐academic pathologists. Methods This study was a side‐study of the ASPRO ( AS piration versus PROcore) study. Five centers retrieved 74 (59%) consecutive FNB and 51 (41%) FNA samples from the ASPRO study according to randomization; 64 (51%) pancreatic and 61 (49%) lymph node specimens. Samples were re‐reviewed by five expert academic and five non‐academic pathologists and rated in terms of sample quality and diagnosis. Ratings were compared between needles, expert academic and non‐academic pathologists, target lesions, and cytology versus histological specimens. Results Besides a higher diagnostic accuracy, FNB also provided for a better agreement on diagnosing malignancy (ĸ = 0.59 vs ĸ = 0.76, P < 0.001) and classification according to Bethesda (ĸ = 0.45 vs ĸ = 0.61, P < 0.001). This equally applied for expert academic and non‐academic pathologists and for pancreatic and lymph node specimens. Sample quality was also rated higher for FNB , but agreement ranged from poor (ĸ = 0.04) to fair (ĸ = 0.55). Histology provided better agreement than cytology, but only when a core specimen was obtained with FNB ( P = 0.004 vs P = 0.432). Conclusion This study shows that the 20‐G FNB outperforms the 25‐G FNA needle in terms of diagnostic agreement, independent of the background and experience of the pathologist. This endorses use of the 20‐G FNB needle in both expert and lower volume EUS centers.