Clin Endosc.  2021 Mar;54(2):229-235. 10.5946/ce.2020.056.

Feasibility and Accuracy of Transduodenal Endoscopic Ultrasound-Guided Fine-Needle Aspiration of Solid Lesions Using a 19-Gauge Flexible Needle: A Multicenter Study

• de Nucci G
• Petrone MC
• Imperatore N
• Forti E
• Grassia R
• Giovanelli S
• Ottaviani L
• Mirante V
• Sabatino G
• Fabbri C
• Manno M
• Arcidiacono PG
• Manes G

• KMID: 2514177
• DOI: http://doi.org/10.5946/ce.2020.056

Abstract

Background/Aims
Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is the go-to method for obtaining samples from gastrointestinal tract and pancreatic lesions. When the transduodenal approach is utilized, the use of a more flexible needle, such as a nitinol 19-gauge (G) needle, has been recommended. The aim of this study was to evaluate the feasibility and accuracy of 19-G flexible aspiration needles in obtaining samples from solid lesions through a transduodenal approach.
Methods
This was a retrospective analysis of prospectively collected data from eight Italian endoscopy centers. Consecutive patients with solid lesions who underwent transduodenal EUS-FNA with a 19-G flexible needle were included.
Results
A total of 201 patients were enrolled. According to histology, EUS, radiology and 12 months of follow-up, 151 patients had malignant lesions and 50 patients had benign lesions. EUS-FNA was feasible in all cases. An adequate histologic sample was obtained in all except eight cases (96.1%). The sensitivity of EUS-FNA was 92.1% (95% confidence interval [CI], 86.8%–95.7%), and the specificity was 100% (95% CI, 90.5%–100%). The positive predictive value was 100% (95% CI, 93.4%–100%), and the negative predictive value was 74% (95% CI, 62.8%–82.7%). The diagnostic accuracy was 93.5% (95% CI, 89.2%–96.5%).
Conclusions
The transduodenal approach for obtaining samples from solid lesions using a 19-G flexible needle seems feasible and accurate.

Keyword

Endoscopic ultrasound-guided fine-needle aspiration; Endosonography; Feasibility studies

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