Endoscopic ultrasound-guided tissue acquisition with or without macroscopic on-site evaluation: Randomized controlled trial

Chong, Charing C. N. and Lakhtakia, Sundeep and Nguyen, Nam and Hara, Kazuo and Chan, Wah Kheong and Puri, Rajesh and Almadi, Majid A. and Ang, Tiing Leong and Kwek, Andrew and Yasuda, Ichiro and Doi, Shinpei and Kida, Mitsuhiro and Wang, Hsiu-Po and Cheng, Tsu-Yao and Jiang, Qingwei and Yang, Aiming and Chan, Anthony W. H. and Chan, Shannon and Tang, Raymond and Iwashita, Takuji and Teoh, Anthony Y. B. (2020) Endoscopic ultrasound-guided tissue acquisition with or without macroscopic on-site evaluation: Randomized controlled trial. Endoscopy, 52 (10). pp. 856-863. ISSN 0013-726X, DOI https://doi.org/10.1055/a-1172-6027.

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Abstract

Background The use of macroscopic on-site evaluation (MOSE) to estimate the adequacy of a specimen for histological diagnosis during endoscopic ultrasound (EUS)-guided fine-needle tissue acquisition (FNTA) has recently been advocated. This study aimed to evaluate the diagnostic yield of MOSE compared with conventional EUS-FNTA without rapid on-site evaluation (ROSE). Methods This was an international, multicenter, prospective, randomized controlled study. After providing informed consent, consecutive adult patients referred for EUS-FNTA for solid lesions larger than 2cm were randomized to a MOSE arm or to a conventional arm without ROSE. A designated cytopathologist from each center performed all cytopathological examinations for that center and was blinded to the randomization results. The primary outcome measure was the diagnostic yield, and the secondary outcomes included sensitivity, specificity, positive predictive value, negative predictive value, diagnostic accuracy, and the rate of procedure-related complications. Results 244 patients (122 conventional, 122 MOSE) were enrolled during the study period. No significant differences between the two arms were found in procedure time or rate of procedure-related adverse events. The diagnostic yield for the MOSE technique (92.6%) was similar to that for the conventional technique (89.3%; P =0.37), with significantly fewer passes made (median: conventional 3, MOSE 2; P <0.001). Conclusions EUS-FNTA with the MOSE technique provided a similar diagnostic yield to conventional EUS-FNTA technique in the absence of ROSE but with fewer passes. This technique can be used when ROSE is not available.

Item Type: Article
Funders: UNSPECIFIED
Uncontrolled Keywords: Adult; Endoscopic Ultrasound-Guided Fine Needle Aspiration; Endosonography; Humans; Needles; Pancreatic Neoplasms; Prospective Studies
Subjects: R Medicine
R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Divisions: Faculty of Medicine
Faculty of Medicine > Medicine Department
Depositing User: Ms Zaharah Ramly
Date Deposited: 30 Nov 2023 03:09
Last Modified: 30 Nov 2023 03:09
URI: http://eprints.um.edu.my/id/eprint/36353

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