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Impact of rapid on‐site evaluation on the adequacy of endoscopic‐ultrasound guided fine‐needle aspiration of solid pancreatic lesions: A systematic review and meta‐analysis
Author(s) -
Matynia Anna P,
Schmidt Robert L,
Barraza Gonzalo,
Layfield Lester J,
Siddiqui Ali A,
Adler Douglas G
Publication year - 2014
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.12431
Subject(s) - medicine , endoscopic ultrasound , meta analysis , fine needle aspiration , confidence interval , context (archaeology) , radiology , nuclear medicine , surgery , biopsy , biology , paleontology
Background Rapid on‐site evaluation ( ROSE ) has the potential to improve adequacy rates for endoscopic ultrasound‐guided fine needle aspiration ( EUS‐FNA ) of solid pancreatic lesions, but its impact is context‐dependent. No studies exist that summarize the relationship between ROSE , number of needle passes, and resulting adequacy rates. Aims To analyze data from previous studies to establish if ROSE is associated with improved adequacy rates; to evaluate the relationship between ROSE , number of needle passes, and the resulting adequacy rates of EUS‐FNA for solid pancreatic lesions. Methods Systematic review and meta‐analysis of studies reporting the adequacy rates for EUS‐FNA of solid pancreatic lesions. Results The search produced 3822 original studies, of which 70 studies met our inclusion criteria. The overall average adequacy rate was 96.2% (95% confidence interval: 95.5, 96.9). ROSE was associated with a statistically significant improvement of up to 3.5% in adequacy rates. There was heterogeneity in adequacy rates across all subgroups. No association between the assessor type and adequacy rates was found. Studies with ROSE have high per‐case adequacy and a relatively high number of needle passes in contrast to non‐ ROSE studies. ROSE is an effect modifier of the relationship between number of needle passes and adequacy. Conclusions ROSE is associated with up to 3.5% improvement in adequacy rates for EUS‐FNA of solid pancreatic lesions. ROSE assessor type has no impact on adequacy rates. ROSE is an effect modifier on the relationship between needle passes and per‐case adequacy for EUS‐FNA of solid pancreatic lesions.