Retrospective Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 6, 2021; 9(34): 10507-10517
Published online Dec 6, 2021. doi: 10.12998/wjcc.v9.i34.10507
Endoscopic ultrasound fine needle aspiration vs fine needle biopsy in solid lesions: A multi-center analysis
Diogo Turiani Hourneaux Moura, Thomas R McCarty, Pichamol Jirapinyo, Igor Braga Ribeiro, Galileu Ferreira Ayala Farias, Antonio Coutinho Madruga-Neto, Marvin Ryou, Christopher C Thompson
Diogo Turiani Hourneaux Moura, Igor Braga Ribeiro, Gastrointestinal Endoscopy Unit, University of Sao Paulo School of Medicine, São Paulo, SP 05403-010, Brazil
Diogo Turiani Hourneaux Moura, Thomas R McCarty, Pichamol Jirapinyo, Marvin Ryou, Christopher C Thompson, Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, United States
Galileu Ferreira Ayala Farias, Antonio Coutinho Madruga-Neto, Division of Gastrointestinal Endoscopy, University of São Paulo Medical School, São Paulo, SP 01246-903, Brazil
Author contributions: de Moura DTH, Jirapinyo P and Ryou M contributed to study concept and design, manuscript preparation, critical revisions; McCarty TR contributed to statistical analyses, data interpretation, critical revisions; Ribeiro IB, Farias GFA and Madruga-Neto AC contributed to acquisition of data, statistical analyses, data interpretation; Thompson CC contributed to critical final review of manuscript/English review; all authors approve of the final version of the manuscript.
Institutional review board statement: The study was approved by the Research Ethics Committee from Partners Human Research (Protocol No. 2003P001665).
Informed consent statement: Written informed consent was obtained from all patients.
Conflict-of-interest statement: Diogo Turiani Hourneaux de Moura, Thomas R McCarty, Pichamol Jirapinyo, Igor Braga Ribeiro, Galileu Ferreira Ayala Farias and Antonio Coutinho Madruga-Neto have nothing to disclose. Marvin Ryou reports other from Medtronic, other from GI Windows, other from EnteraSense, other from FujiFilm, other from Boston Scientific, grants from Olympus, other from Pentax, outside the submitted work. Christopher C Thompson reports personal fees from Medtronic, personal fees from Boston Scientific, grants from USGE Medical, grants from Apollo Endosurgery, grants from Olympus, outside the submitted work.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Igor Braga Ribeiro, MD, Associate Research Scientist, Surgeon, Gastrointestinal Endoscopy Unit, University of Sao Paulo School of Medicine, Av. Dr. Enéas de Carvalho Aguiar, 255 – Instituto Central - Prédio dos Ambulatórios, São Paulo, SP 05403-010, Brazil.
Received: March 25, 2021
Peer-review started: March 25, 2021
First decision: July 15, 2021
Revised: July 24, 2021
Accepted: October 20, 2021
Article in press: October 20, 2021
Published online: December 6, 2021
Research background

While endoscopic ultrasound (EUS)-guided fine needle aspiration (FNA) is considered a preferred technique for tissue sampling for solid lesions, fine needle biopsy (FNB) has recently been developed with the capability of tissue extraction for histological evaluation.

Research motivation

To better understand the comparative effectiveness of FNA vs FNB and possible advantages of EUS-guided FNB for solid lesions in daily clinical practice

Research objectives

Evaluate the diagnostic test characteristics of EUS-FNA and EUS-FNB sampling techniques with and without rapid on-site evaluation (ROSE).

Research methods

Multi-center, retrospective study conducted at 5 hospitals in Massachusetts, United States following the Standards for the Reporting of Diagnostic accuracy studies recommendations.

Research results

A total of 1168 patients with solid lesions underwent EUS-guided sampling. Overall, sensitivity, specificity and accuracy were superior for FNB vs FNA. On subgroup analyses, sensitivity, specificity, and accuracy of FNB alone were similar to FNA + ROSE. There were no difference in diagnostic yield of FNB alone vs FNB + ROSE.

Research conclusions

FNB is superior to FNA with equivalent diagnostic test characteristics compared to FNA + ROSE in the diagnosis of non-pancreatic solid lesions.

Research perspectives

Our results suggest that EUS-FNB may eliminate the need of ROSE and should be employed as a first-line method in the diagnosis of solid lesions.