Format

Send to

Choose Destination
Gastrointest Endosc. 2015 Jan;81(1):177-85. doi: 10.1016/j.gie.2014.08.040. Epub 2014 Oct 29.

Macroscopic on-site quality evaluation of biopsy specimens to improve the diagnostic accuracy during EUS-guided FNA using a 19-gauge needle for solid lesions: a single-center prospective pilot study (MOSE study).

Author information

1
First Department of Internal Medicine, Gifu University Hospital, Gifu, Japan.
2
Department of Gastroenterology, Teikyo University Mizonokuchi Hospital, Kanagawa, Japan.
3
Department of Tumor Pathology, Gifu University Graduate School of Medicine, Gifu, Japan.

Abstract

BACKGROUND:

Although rapid on-site cytologic evaluation provides high efficacy of EUS-guided FNA (EUS-FNA), its availability is limited. Alternatively, macroscopic on-site quality evaluation (MOSE) may increase the efficacy of EUS-FNA.

OBJECTIVE:

To assess the efficacy of MOSE in estimating the adequacy of histologic core specimens obtained by EUS-FNA using a standard 19-gauge needle (19GN) for solid lesions.

DESIGN:

A prospective pilot study.

SETTING:

Tertiary-care referral center.

PATIENTS:

One hundred patients with solid lesions (n = 111 lesions).

INTERVENTIONS:

EUS-FNA using 19GN MAIN OUTCOME MEASUREMENTS: The relation of a macroscopic visible core (MVC) in the FNA specimens on MOSE with histologic core and the diagnostic yields were studied.

RESULTS:

The feasibility of EUS-FNA using a 19GN was 99%. The final diagnoses were malignancy in 83 lesions and benign in 28. MOSE revealed MVC in 91.1% with the median length of 8 mm. Histologic core was confirmed in 78.9%. The receiver-operating characteristic curve of the length of MVC for the presence of histologic core showed the cut-off MVC length of 4 mm with area under the curve of .893. Comparisons of per-pass diagnostic yields showed significantly superior histologic, cytologic, and overall diagnostic yields in MVC ≥ 4 mm as compared with <4 mm. The multivariate analysis for false-negative pass identified lesion in the pancreas and MVC < 4 mm as significant risk factors. No adverse events were seen.

LIMITATIONS:

Single center, limited operators

CONCLUSION:

MVC of ≥4 mm on MOSE can be an indicator of specimen adequacy and can improve diagnostic yield; however, additional FNA may be recommended for pancreatic lesions. (

CLINICAL TRIAL REGISTRATION NUMBER:

UMIN000010417.).

PMID:
25440688
DOI:
10.1016/j.gie.2014.08.040
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center