Rapid on‐site evaluation improves the sensitivity of endoscopic ultrasound‐guided fine needle aspiration (EUS‐FNA) for solid pancreatic lesions irrespective of technique: A single‐centre experience

Abstract

AbstractObjectiveEndoscopic ultrasound‐guided fine needle aspiration (EUS‐FNA) is the first‐line technique for the sampling of pancreatic lesions. Many factors can influence the diagnostic performance of this procedure, including the use of rapid on‐site evaluation (ROSE). The primary aim of this study was to compare the adequacy, diagnostic yield, accuracy, sensitivity and specificity of EUS‐FNA for solid pancreatic lesions before and after the introduction of ROSE.MethodsThis retrospective single‐centre study evaluated all consecutive patients who underwent EUS‐FNA for suspicious, solid pancreatic masses from April 2012 to March 2015. We compared the findings of EUS‐FNA procedures performed during the first and second years following the adoption of ROSE (“ROSE1” and “ROSE2”, respectively) to those performed the year before ROSE introduction (the “pre‐ROSE” group).ResultsNinety‐one consecutive patients with a total of 93 pancreatic lesions were enrolled. For the pre‐ROSE, ROSE1 and ROSE2 groups, the adequacy rates were 96.2%, 96.6% and 100%, the diagnostic yield values were 76.9%, 89.7% and 92.1% and accuracy values were 69.2%, 86.2% and 89.5% (p = NS). Sensitivity for malignancy improved from 63.7% in the pre‐ROSE group to 91.7% and 91.2% in the post‐ROSE groups (p < 0.05). Specificity for malignancy was 100% in all groups.ConclusionsROSE can improve the diagnostic performance of EUS‐FNA for solid pancreatic lesions, although only sensitivity reached statistical significance.