Endoscopic ultrasound-guided fine-needle aspiration biopsy using linear array and radial scanning endosonography

F. G. Gress, R. H. Hawes, T. J. Savides, S. O. Ikenberry, Glen Lehman

Research output: Contribution to journalArticle

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Abstract

Background: Endoscopic ultrasound (EUS) accurately stages gastrointestinal malignancies but is less able to differentiate between neoplastic and inflammatory processes. EUS-guided fine-needle aspiration (EUS FNA) has been reported useful for obtaining a diagnosis in suspected gastrointestinal lesions. We report our entire experience with EUS FNA using both radial and linear array endosonography, including our diagnostic accuracy and complication rate. Methods: Two hundred eight consecutive patients (119 men, 89 women) referred for EUS evaluation of suspected gastrointestinal or mediastinal masses underwent EUS-guided FNA. We performed EUS FNA using radial scanning or linear array endosonography and a 23 gauge, 4 cm needle or a 22 guage, 12 cm needle. Data collected included lesion types, number of passes, complications, and diagnostic accuracy. Results: Two hundred eight lesions were targeted, with a total of 705 FNA passes (mean 3.39 passes/patient). Overall diagnostic accuracy for our study population was 87% with a 89% sensitivity and 100% specificity. The diagnostic accuracy for each subgroup was 95% for mediastinal lymph node, 85% for intra-abdominal lymph node, 85% for pancreatic, 84% for submucosal, and 100% for perirectal masses. EUS FNA provided an adequate specimen in 90% of patients. The FNA results were similar for both types of endosonography. We observed immediate complications in 2% (4 of 208) of patients. All complications occurred with EUS FNA of pancreatic lesions and consisted of bleeding and pancreatitis in 2 patients each. For EUS FNA of pancreatic masses there was a 1.2% (2 of 121) risk of pancreatitis, 1% (1/121) risk of severe bleeding, and risk of death in less than 1%. Conclusions: EUS-guided FNA appears to be technically feasible, safe, and accurate for obtaining diagnostic tissue of suspicious gastrointestinal and mediastinal lesions and provides important preoperative information.

Original languageEnglish
Pages (from-to)243-250
Number of pages8
JournalGastrointestinal Endoscopy
Volume45
Issue number3
DOIs
StatePublished - 1997

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Endoscopic Ultrasound-Guided Fine Needle Aspiration
Endosonography
Fine Needle Biopsy
Pancreatitis
Needles
Lymph Nodes
Hemorrhage
Neoplastic Processes
Sensitivity and Specificity
Population
Neoplasms

ASJC Scopus subject areas

  • Gastroenterology

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Endoscopic ultrasound-guided fine-needle aspiration biopsy using linear array and radial scanning endosonography. / Gress, F. G.; Hawes, R. H.; Savides, T. J.; Ikenberry, S. O.; Lehman, Glen.

In: Gastrointestinal Endoscopy, Vol. 45, No. 3, 1997, p. 243-250.

Research output: Contribution to journalArticle

Gress, F. G. ; Hawes, R. H. ; Savides, T. J. ; Ikenberry, S. O. ; Lehman, Glen. / Endoscopic ultrasound-guided fine-needle aspiration biopsy using linear array and radial scanning endosonography. In: Gastrointestinal Endoscopy. 1997 ; Vol. 45, No. 3. pp. 243-250.
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abstract = "Background: Endoscopic ultrasound (EUS) accurately stages gastrointestinal malignancies but is less able to differentiate between neoplastic and inflammatory processes. EUS-guided fine-needle aspiration (EUS FNA) has been reported useful for obtaining a diagnosis in suspected gastrointestinal lesions. We report our entire experience with EUS FNA using both radial and linear array endosonography, including our diagnostic accuracy and complication rate. Methods: Two hundred eight consecutive patients (119 men, 89 women) referred for EUS evaluation of suspected gastrointestinal or mediastinal masses underwent EUS-guided FNA. We performed EUS FNA using radial scanning or linear array endosonography and a 23 gauge, 4 cm needle or a 22 guage, 12 cm needle. Data collected included lesion types, number of passes, complications, and diagnostic accuracy. Results: Two hundred eight lesions were targeted, with a total of 705 FNA passes (mean 3.39 passes/patient). Overall diagnostic accuracy for our study population was 87{\%} with a 89{\%} sensitivity and 100{\%} specificity. The diagnostic accuracy for each subgroup was 95{\%} for mediastinal lymph node, 85{\%} for intra-abdominal lymph node, 85{\%} for pancreatic, 84{\%} for submucosal, and 100{\%} for perirectal masses. EUS FNA provided an adequate specimen in 90{\%} of patients. The FNA results were similar for both types of endosonography. We observed immediate complications in 2{\%} (4 of 208) of patients. All complications occurred with EUS FNA of pancreatic lesions and consisted of bleeding and pancreatitis in 2 patients each. For EUS FNA of pancreatic masses there was a 1.2{\%} (2 of 121) risk of pancreatitis, 1{\%} (1/121) risk of severe bleeding, and risk of death in less than 1{\%}. Conclusions: EUS-guided FNA appears to be technically feasible, safe, and accurate for obtaining diagnostic tissue of suspicious gastrointestinal and mediastinal lesions and provides important preoperative information.",
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AU - Hawes, R. H.

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AU - Lehman, Glen

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AB - Background: Endoscopic ultrasound (EUS) accurately stages gastrointestinal malignancies but is less able to differentiate between neoplastic and inflammatory processes. EUS-guided fine-needle aspiration (EUS FNA) has been reported useful for obtaining a diagnosis in suspected gastrointestinal lesions. We report our entire experience with EUS FNA using both radial and linear array endosonography, including our diagnostic accuracy and complication rate. Methods: Two hundred eight consecutive patients (119 men, 89 women) referred for EUS evaluation of suspected gastrointestinal or mediastinal masses underwent EUS-guided FNA. We performed EUS FNA using radial scanning or linear array endosonography and a 23 gauge, 4 cm needle or a 22 guage, 12 cm needle. Data collected included lesion types, number of passes, complications, and diagnostic accuracy. Results: Two hundred eight lesions were targeted, with a total of 705 FNA passes (mean 3.39 passes/patient). Overall diagnostic accuracy for our study population was 87% with a 89% sensitivity and 100% specificity. The diagnostic accuracy for each subgroup was 95% for mediastinal lymph node, 85% for intra-abdominal lymph node, 85% for pancreatic, 84% for submucosal, and 100% for perirectal masses. EUS FNA provided an adequate specimen in 90% of patients. The FNA results were similar for both types of endosonography. We observed immediate complications in 2% (4 of 208) of patients. All complications occurred with EUS FNA of pancreatic lesions and consisted of bleeding and pancreatitis in 2 patients each. For EUS FNA of pancreatic masses there was a 1.2% (2 of 121) risk of pancreatitis, 1% (1/121) risk of severe bleeding, and risk of death in less than 1%. Conclusions: EUS-guided FNA appears to be technically feasible, safe, and accurate for obtaining diagnostic tissue of suspicious gastrointestinal and mediastinal lesions and provides important preoperative information.

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