Abstract
To compare the diagnostic yield of three techniques of tissue preparation for EUS-guided tissue acquisition without ROSE. Patients who were referred for EUS-FNA of peri-gastrointestinal masses were recruited. Without ROSE, each lesion was biopsied with three needle passes, and the order in which tissue is prepared was randomized to either (i) CS+CB, (ii) CB only, or (iii) DH only. The prepared specimens were reviewed. A total of 243 specimens were taken from 81 patients. Tissue diagnosis was achieved in 78/81 (96.3%) of patients, including 63 neoplasms (PDAC [n=45], pancreatic neuroendocrine tumors [PNET; n=4], cholangiocarcinoma [n=5], metastatic disease [n=4], lymphoma [n=1], linitis plastica [n=2], leiomyoma [n=2]) and 15 benign pathologies (chronic pancreatitis [n=8], reactive nodes [n=5], inflammatory biliary stricture [n=1], and pancreatic rest [n=1]). The three non-diagnostic cases were found to be PDAC (n=2) and PNET (n=1). Sensitivity and diagnostic accuracy was highest with DH (94 and 95%), which was significantly better than that by CS+CB (43 and 54%; P=0.0001) and CB-only preparations (32 and 48.6%; P<0.0001). There was no significant difference between the CS+CB and CB-only arms (P>0.22). Without ROSE, our findings suggest that with just a single pass, DH should be the tissue preparation method of choice given its significantly higher diagnostic accuracy compared with CS and/or CB techniques.
Published Version
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