Connect your needle to a smartphone to increase EUS FNA sample quality and diagnostic accuracy of solid pancreatic masses: a randomized trial

Abstract

Background and study aims. EUS FNA is recommended for diagnosis of solid pancreatic masses. We aimed to evaluate if a high needle movement acceleration value during puncture increases diagnostic accuracy. Patients and methods. EUS FNA needle acceleration was measured using a PocketLab accelerometer connected by Bluetooth to a smartphone. Two passes (fast and slow) with higher and respectively lower than 1g needle acceleration values were performed in random order. Sample cellularity and quality were measured by semiquantitative scales. Results. 51 patients were included (32 women, mean age 63). Mean acceleration values were 1.59 ± 0.66g for fast pass and 0.32 ± 0.19g for slow pass, p < 10-3. Fast pass yielded significantly higher EUS FNA accuracy (84.3% vs. 68.6%, p = 0.021) and adequate quality scores (94.1% vs. 76.5%, p = 0.007). High cellularity score frequencies were similar (15.7% vs. 11.8%, p = 0.317). Conclusions. A higher than 1g EUS FNA needle acceleration may increase diagnostic accuracy and specimen quality of pancreatic solid lesions.