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CC BY-NC-ND 4.0 · Endosc Int Open 2021; 09(06): E853-E862
DOI: 10.1055/a-1381-7301
Original article

Comparative diagnostic accuracy of EUS needles in solid pancreatic masses: a network meta-analysis

Samuel Han
 1   Division of Gastroenterology, Hepatology, and Nutrition, The Ohio State University Wexner Medical Center, Columbus, OH
,
Furqan Bhullar
 2   Division of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, Maryland, United States
,
Omar Alaber
 3   Division of Gastroenterology and Liver Disease, University Hospitals, Cleveland, Ohio, United States
,
Ayesha Kamal
 2   Division of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, Maryland, United States
,
Puanani Hopson
 4   Division of Pediatric Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, United States
,
Kavin Kanthasamy
 2   Division of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, Maryland, United States
,
Sarah Coughlin
 5   Division of Gastroenterology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, United States
,
Livia Archibugi
 6   Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
,
Nikhil Thiruvengadam
 5   Division of Gastroenterology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, United States
,
Christopher Moreau
 7   Division of Gastroenterology, University of Texas Health San Antonio, San Antonio, Texas, United States
,
David Jin
 8   Division of Gastroenterology, Hepatology, and Endoscopy, Brigham and Women’s Hospital, Boston, Massachusetts, United States
,
Pedram Paragomi
 9   Division of Gastroenterology, Hepatology, and Nutrition, University of Pittsburgh, Pittsburgh, Pennsylvania, United States
,
Francisco Valverde-López
10   Division of Gastroenterology, Hospital Universitario Virgen de las Nieves, Granada, Spain
,
Sajan Nagpal
11   Division of Gastroenterology, Hepatology, and Nutrition. University of Chicago, Chicago, Illinois, United States
,
Cemal Yazici
12   Division of Gastroenterology and Hepatology, University of Illinois at Chicago, Chicago, Illinois, United States
,
Georgios Papachristou
 1   Division of Gastroenterology, Hepatology, and Nutrition, The Ohio State University Wexner Medical Center, Columbus, OH
,
Peter J Lee
 5   Division of Gastroenterology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, United States
,
Venkata Akshintala
 2   Division of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, Maryland, United States
,
on behalf of the Collaborative Alliance for Pancreatic Education and Research (CAPER) › Author Affiliations
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Comparative diagnostic accuracy of EUS needles in solid pancreatic masses: a network meta-analysisEndosc Int Open 2021; 09(06): C5-C5
DOI: 10.1055/a-1521-0166

Abstract

Background and study aims Endoscopic ultrasound (EUS)-guided tissue sampling is the standard of care for diagnosing solid pancreatic lesions. While many two-way comparisons between needle types have been made in randomized controlled trials (RCTs), it is unclear which size and type of needle offers the best probability of diagnosis. We therefore performed a network meta-analysis (NMA) to compare different sized and shaped needles to rank the diagnostic performance of each needle.

Methods We searched MEDLINE, EMBASE and Cochrane Library databases through August, 2020 for RCTs that compared the diagnostic accuracy of EUS fine-needle aspiration (FNA) and biopsy (FNB) needles in solid pancreatic masses. Using a random-effects NMA under the frequentist framework, RCTs were analyzed to identify the best needle type and sampling technique. Performance scores (P-scores) were used to rank the different needles based on pooled diagnostic accuracy. The NMA model was used to calculate pairwise relative risk (RR) with 95 % confidence intervals.

Results Review of 2577 studies yielded 29 RCTs for quantitative synthesis, comparing 13 different needle types. All 22G FNB needles had an RR > 1 compared to the reference 22G FNA (Cook) needle. The highest P-scores were seen with the 22G Medtronic FNB needle (0.9279), followed by the 22G Olympus FNB needle (0.8962) and the 22G Boston Scientific FNB needle (0.8739). Diagnostic accuracy was not significantly different between needles with or without suction.

Conclusions In comparison to FNA needles, FNB needles offer the highest diagnostic performance in sampling pancreatic masses, particularly with 22G FNB needles.

Supplementary material



Publication History

Received: 19 October 2020

Accepted: 11 January 2021

Article published online:
27 May 2021

© 2021. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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