Cancer Diagnosis Program | Biorepositories and Biospecimen Research Branch

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Comparison of Ultrasound-Guided Core Needle Biopsy and Endoscopic Ultrasound-Guided Fine-Needle Aspiration for Solid Pancreatic Lesions.

Author(s): Sur YK, Kim YC, Kim JK, Lee JH, Yoo BM, Kim YB

Publication: J Ultrasound Med, 2015, Vol. 34, Page 2163-9

PubMed ID: 26491091 PubMed Review Paper? No

Purpose of Paper

Conclusion of Paper

Studies

1. Study Purpose

   The purpose of this study was to compare diagnostic accuracy, sensitivity and specificity between US-CNB and EU-FNA specimens of solid pancreatic lesions. A total of 63 EUS-guided FNA specimens procured with a 25-gauge needle, and 35 US-guided CNB specimens procured with an 18-gauge needle were obtained from 89 patients with solid pancreatic lesions identified by CT or magnetic resonance imaging (MRI). Biopsy method was determined by the clinician, but clinicians favored EUS-FNA when possible based on location unless the lesion was suspect for pancreatitis. The 35 US-CNB specimens included 10 cases in which the initial diagnosis by EUS-FNA was presumed inaccurate. Malignant lesions were confirmed after surgical resection. Benign pancreatic lesions were confirmed by US-CNB or by clinical or imaging follow-up after 1 year.

   Summary of Findings:

   Overall the diagnostic accuracy of US-guided CNB was 88.57% (31 of 35 cases), which did not differ significantly from EUS-guided FNA (73.02%, 46 of 63 cases). However, when specimens that failed due to technical issues were included the proportion of specimens with an accurate diagnosis was significantly higher for US-CNB than EUS-FNA (86.11% versus 65.71%, p=0.035). US-CNB rather than EUS-FNA was more likely to correctly diagnose malignant (sensitivity of 87.10% versus 77.78%) and benign lesions (specificity of 100% versus 44.44%), but the differences were not significant, regardless of lesion size or location within the pancreas. Generally, diagnostic accuracy and diagnosis rate increased with increasing the lesion size. 

   Biospecimens

   • Tissue - Pancreas

   Preservative Types

   • Formalin

   Diagnoses:

   • Other diagnoses
   • Neoplastic - Benign
   • Neoplastic - Carcinoma
   • Normal

   Platform:

   Analyte	Technology Platform
   Morphology	Light microscopy

   Pre-analytical Factors:

   Classification	Pre-analytical Factor	Value(s)
   Biospecimen Acquisition	Method of tissue acquisition	Fine needle aspiration Core needle biopsy Ultrasound-guided biopsy Ultrasound-guided fine needle aspiration
   Preaquisition	Prognostic factor	<2 cm lesion 2-4 cm lesion >4 cm lesion
   Biospecimen Acquisition	Biospecimen location	Pancreatic head and uncinate Pancreatic body and neck

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