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J Ultrasound Med. 2015 Dec;34(12):2163-9. doi: 10.7863/ultra.14.11030. Epub 2015 Oct 21.

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

Author information

1
Departments of Radiology (Y.K.S., Y.C.K., J.K.K., J.H.L.), Gastroenterology (B.M.Y.), and Pathology (Y.B.K.), Ajou University School of Medicine, Suwon, Korea.
2
Departments of Radiology (Y.K.S., Y.C.K., J.K.K., J.H.L.), Gastroenterology (B.M.Y.), and Pathology (Y.B.K.), Ajou University School of Medicine, Suwon, Korea. yochoru@gmail.com.

Abstract

OBJECTIVES:

The objective of our study was to compare the diagnostic yield of endoscopic ultrasound (EUS)-guided fine-needle aspiration (FNA) using a 25-gauge needle and ultrasound (US)-guided core needle biopsy (CNB) using an 18-gauge core needle for diagnosis of solid pancreatic lesions.

METHODS:

This retrospective study was approved by our Institutional Review Board, and the requirement for informed consent was waived. Patients who underwent either EUS-guided FNA or US-guided CNB for a solid pancreatic lesion from January 2008 to December 2012 were included and reviewed. Fine-needle aspirations and CNBs were performed by experienced endoscopists and radiologists. The diagnostic yield, accuracy, technical failure rate, sensitivity, and specificity for malignancy were calculated and compared.

RESULTS:

A total of 106 biopsy attempts were undertaken in 89 patients (EUS-guided FNA, n = 70; US-guided CNB, n = 36). Biopsy specimens were successfully obtained in 98 biopsy attempts (EUS-guided FNA, n = 63; US-guided CNB, n = 35). The accuracy, technical failure rate, sensitivity, and specificity of EUS-guided FNA for malignancy (73.02%, 10.00%, 77.78%, and 44.44%, respectively) was not significantly different from those of US-guided CNB (88.57%, 2.78%, 87.10%, and 100%, respectively; P ≥ .089). Diagnostic performance did not differ between the modalities according to the size and the location of the lesion in the pancreas. However, the diagnostic yield of US-guided CNB (86.11%) was higher than that of EUS-guided FNA (65.71%, P = .035).

CONCLUSIONS:

The diagnostic yield of US-guided CNB for solid pancreatic lesions is superior to that of EUS-guided FNA.

KEYWORDS:

diagnostic yield; endoscopic ultrasound-guided fine-needle aspiration; gastrointestinal ultrasound; pancreatic malignancy; pancreatitis; ultrasound-guided core needle biopsy

PMID:
26491091
DOI:
10.7863/ultra.14.11030
[Indexed for MEDLINE]

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