Endoscopy 2019; 51(04): S113
DOI: 10.1055/s-0039-1681504
ESGE Days 2019 oral presentations
Saturday, April 6, 2019 11:00 – 13:00: Best abstract awards Congress Hall
Georg Thieme Verlag KG Stuttgart · New York

A RANDOMIZED CONTROLLED TRIAL ON THE CONTRAST ENHANCED GUIDED EUS-FNA AGAINST STANDARD EUS-FNA IN DIAGNOSING THE SOLID PANCREATIC LESIONS

A Seicean
1   University of Medicine and Pharmacy Iuliu Hatieganu Cluj-Napoca, Cluj-Napoca, Romania
,
A Samarghitan
2   Medlife Hospital, Cluj-Napoca, Romania
,
C Pojoga
3   Regional Institute of Gastroenterology and Hepatology, Cluj-Napoca, Romania
,
I Rusu
3   Regional Institute of Gastroenterology and Hepatology, Cluj-Napoca, Romania
,
M Gheorghiu
3   Regional Institute of Gastroenterology and Hepatology, Cluj-Napoca, Romania
,
Z Sparchez
1   University of Medicine and Pharmacy Iuliu Hatieganu Cluj-Napoca, Cluj-Napoca, Romania
,
N Al Hajjar
1   University of Medicine and Pharmacy Iuliu Hatieganu Cluj-Napoca, Cluj-Napoca, Romania
,
R Seicean
1   University of Medicine and Pharmacy Iuliu Hatieganu Cluj-Napoca, Cluj-Napoca, Romania
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

 

Aims:

To assess the efficiency of the contrast enhanced guided endoscopic ultrasound fine needle aspiration (CH-EUS-FNA) in comparison to standard endoscopic ultrasound fine needle aspiration (EUS-FNA) in diagnosing the solid pancreatic masses.

Methods:

This randomized controlled study included patients with the suspicion of pancreatic solid masses on transabdominal ultrasound or CT scan admitted in one academic medical center. There were excluded patients with cystic component more than 20% or patients with previous biliary or duodenal stenting. Two passes with 22G standard FNA needle were done in random order (established by computer at the start of the study) by using EUS-FNA or CH-EUS-FNA. For contrast assessment the contrast substance used was 2.4 ml Sonovue for each patient and the low mechanical index was 0.20. The diagnosis of EUS-FNA was based on the pathology analysis of visible core. The final diagnosis was based on EUS-FNA or surgical specimen results and on following up data every three month by imaging methods for at least six months.

Results:

There were included 150 patients and two of them were lost during follow-up. There were 99 adenocarcinoma, 13 neuroendocrine tumors, 3 schwanomma, 3 cholangiocarcinoma, 11 metastases, 19 benign lesions.

The EUS-FNA pass and the CH-EUS FNA pass had the accuracy of diagnosis of 86.48% and 89.18%, respectively (p = NS), and the global accuracy of the two passes was 93.2%. All the false negative cases on CH-EUS-FNA were hypoenhanced. No difference between the two FNA passes was seen regardless the location, size or tumor stage.

Conclusions:

The diagnostic rate of core obtained by using 22G FNA needles with standard EUS-FNA and guided CH-EUS-FNA did not differ statistically.