EUS-guided FNA diagnostic yield of malignancy in solid pancreatic masses

a benchmark for quality performance measurement

Thomas J. Savides, Michael Donohue, Gordon Hunt, Mohammed Al-Haddad, Harry Aslanian, Tamir Ben-Menachem, Victor K. Chen, Coyle Walter Coyle, John Deutsch, John DeWitt, Manish Dhawan, Alexander Eckardt, Mohamad Eloubeidi, Alec Esker, Stuart R. Gordon, Frank Gress, Steven Ikenberry, Ann Marie Joyce, Jason Klapman, Simon Lo & 5 others Fauze Maluf-Filho, Nicholas Nickl, Virmeet Singh, Jason Wills, Cynthia Behling

Research output: Contribution to journalArticle

118 Citations (Scopus)

Abstract

Background: The diagnostic yield of EUS-guided FNA (EUS-FNA) of solid pancreatic masses is a potential benchmark for EUS-FNA quality, because the majority of EUS-FNA of solid pancreatic masses should be diagnostic for malignancy. Objectives: To determine the cytologic diagnostic rate of malignancy in EUS-FNA of solid pancreatic masses and to determine if variability exists among endoscopists and centers. Design: Multicenter retrospective study. Patients: EUS centers provided cytology reports for all EUS-FNAs of solid, noncystic, ≥10-mm-diameter, solid pancreatic masses during a 1-year period. Main Outcome Measurement: Cytology diagnostic of pancreatic malignancy. Results: A total of 1075 patients underwent EUS-FNA at 21 centers (81% academic) with 41 endoscopists. The median number of EUS-FNA of solid pancreatic masses performed during the year per center was 46 (range, 4-177) and per endoscopist was 19 (range, 1-97). The mean mass dimensions were 32 × 27 mm, with 73% located in the head. The mean number of passes was 3.5. Of the centers, 90% used immediate cytologic evaluation. The overall diagnostic rate of malignancy was 71%, 95% confidence interval 0.69%-0.74%, with 5% suspicious for malignancy, 6% atypical cells, and 18% negative for malignancy. The median diagnostic rate per center was 78% (range, 39%-93%; 1st quartile, 61%) and per endoscopist was 75% (range, 0%-100%; 1st quartile, 52%). Limitations: Retrospective study, participation bias, and varying chronic pancreatitis prevalence. Conclusions: (1) EUS-FNA cytology was diagnostic of malignancy in 71% of solid pancreatic masses and (2) endoscopists with a final cytologic diagnosis rate of malignancy for EUS-FNA of solid masses that was less than 52% were in the lowest quartile and should evaluate reasons for their low yield.

Original languageEnglish (US)
Pages (from-to)277-282
Number of pages6
JournalGastrointestinal Endoscopy
Volume66
Issue number2
DOIs
StatePublished - Aug 2007
Externally publishedYes

Fingerprint

Endoscopic Ultrasound-Guided Fine Needle Aspiration
Benchmarking
Neoplasms
Cell Biology
Retrospective Studies
Chronic Pancreatitis
Multicenter Studies
Head
Confidence Intervals

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Savides, T. J., Donohue, M., Hunt, G., Al-Haddad, M., Aslanian, H., Ben-Menachem, T., ... Behling, C. (2007). EUS-guided FNA diagnostic yield of malignancy in solid pancreatic masses: a benchmark for quality performance measurement. Gastrointestinal Endoscopy, 66(2), 277-282. https://doi.org/10.1016/j.gie.2007.01.017

EUS-guided FNA diagnostic yield of malignancy in solid pancreatic masses : a benchmark for quality performance measurement. / Savides, Thomas J.; Donohue, Michael; Hunt, Gordon; Al-Haddad, Mohammed; Aslanian, Harry; Ben-Menachem, Tamir; Chen, Victor K.; Walter Coyle, Coyle; Deutsch, John; DeWitt, John; Dhawan, Manish; Eckardt, Alexander; Eloubeidi, Mohamad; Esker, Alec; Gordon, Stuart R.; Gress, Frank; Ikenberry, Steven; Joyce, Ann Marie; Klapman, Jason; Lo, Simon; Maluf-Filho, Fauze; Nickl, Nicholas; Singh, Virmeet; Wills, Jason; Behling, Cynthia.

In: Gastrointestinal Endoscopy, Vol. 66, No. 2, 08.2007, p. 277-282.

Research output: Contribution to journalArticle

Savides, TJ, Donohue, M, Hunt, G, Al-Haddad, M, Aslanian, H, Ben-Menachem, T, Chen, VK, Walter Coyle, C, Deutsch, J, DeWitt, J, Dhawan, M, Eckardt, A, Eloubeidi, M, Esker, A, Gordon, SR, Gress, F, Ikenberry, S, Joyce, AM, Klapman, J, Lo, S, Maluf-Filho, F, Nickl, N, Singh, V, Wills, J & Behling, C 2007, 'EUS-guided FNA diagnostic yield of malignancy in solid pancreatic masses: a benchmark for quality performance measurement', Gastrointestinal Endoscopy, vol. 66, no. 2, pp. 277-282. https://doi.org/10.1016/j.gie.2007.01.017
Savides, Thomas J. ; Donohue, Michael ; Hunt, Gordon ; Al-Haddad, Mohammed ; Aslanian, Harry ; Ben-Menachem, Tamir ; Chen, Victor K. ; Walter Coyle, Coyle ; Deutsch, John ; DeWitt, John ; Dhawan, Manish ; Eckardt, Alexander ; Eloubeidi, Mohamad ; Esker, Alec ; Gordon, Stuart R. ; Gress, Frank ; Ikenberry, Steven ; Joyce, Ann Marie ; Klapman, Jason ; Lo, Simon ; Maluf-Filho, Fauze ; Nickl, Nicholas ; Singh, Virmeet ; Wills, Jason ; Behling, Cynthia. / EUS-guided FNA diagnostic yield of malignancy in solid pancreatic masses : a benchmark for quality performance measurement. In: Gastrointestinal Endoscopy. 2007 ; Vol. 66, No. 2. pp. 277-282.
@article{ebf88daea61b4ea8800784e12f64f22d,
title = "EUS-guided FNA diagnostic yield of malignancy in solid pancreatic masses: a benchmark for quality performance measurement",
abstract = "Background: The diagnostic yield of EUS-guided FNA (EUS-FNA) of solid pancreatic masses is a potential benchmark for EUS-FNA quality, because the majority of EUS-FNA of solid pancreatic masses should be diagnostic for malignancy. Objectives: To determine the cytologic diagnostic rate of malignancy in EUS-FNA of solid pancreatic masses and to determine if variability exists among endoscopists and centers. Design: Multicenter retrospective study. Patients: EUS centers provided cytology reports for all EUS-FNAs of solid, noncystic, ≥10-mm-diameter, solid pancreatic masses during a 1-year period. Main Outcome Measurement: Cytology diagnostic of pancreatic malignancy. Results: A total of 1075 patients underwent EUS-FNA at 21 centers (81{\%} academic) with 41 endoscopists. The median number of EUS-FNA of solid pancreatic masses performed during the year per center was 46 (range, 4-177) and per endoscopist was 19 (range, 1-97). The mean mass dimensions were 32 × 27 mm, with 73{\%} located in the head. The mean number of passes was 3.5. Of the centers, 90{\%} used immediate cytologic evaluation. The overall diagnostic rate of malignancy was 71{\%}, 95{\%} confidence interval 0.69{\%}-0.74{\%}, with 5{\%} suspicious for malignancy, 6{\%} atypical cells, and 18{\%} negative for malignancy. The median diagnostic rate per center was 78{\%} (range, 39{\%}-93{\%}; 1st quartile, 61{\%}) and per endoscopist was 75{\%} (range, 0{\%}-100{\%}; 1st quartile, 52{\%}). Limitations: Retrospective study, participation bias, and varying chronic pancreatitis prevalence. Conclusions: (1) EUS-FNA cytology was diagnostic of malignancy in 71{\%} of solid pancreatic masses and (2) endoscopists with a final cytologic diagnosis rate of malignancy for EUS-FNA of solid masses that was less than 52{\%} were in the lowest quartile and should evaluate reasons for their low yield.",
author = "Savides, {Thomas J.} and Michael Donohue and Gordon Hunt and Mohammed Al-Haddad and Harry Aslanian and Tamir Ben-Menachem and Chen, {Victor K.} and {Walter Coyle}, Coyle and John Deutsch and John DeWitt and Manish Dhawan and Alexander Eckardt and Mohamad Eloubeidi and Alec Esker and Gordon, {Stuart R.} and Frank Gress and Steven Ikenberry and Joyce, {Ann Marie} and Jason Klapman and Simon Lo and Fauze Maluf-Filho and Nicholas Nickl and Virmeet Singh and Jason Wills and Cynthia Behling",
year = "2007",
month = "8",
doi = "10.1016/j.gie.2007.01.017",
language = "English (US)",
volume = "66",
pages = "277--282",
journal = "Gastrointestinal Endoscopy",
issn = "0016-5107",
publisher = "Mosby Inc.",
number = "2",

}

TY - JOUR

T1 - EUS-guided FNA diagnostic yield of malignancy in solid pancreatic masses

T2 - a benchmark for quality performance measurement

AU - Savides, Thomas J.

AU - Donohue, Michael

AU - Hunt, Gordon

AU - Al-Haddad, Mohammed

AU - Aslanian, Harry

AU - Ben-Menachem, Tamir

AU - Chen, Victor K.

AU - Walter Coyle, Coyle

AU - Deutsch, John

AU - DeWitt, John

AU - Dhawan, Manish

AU - Eckardt, Alexander

AU - Eloubeidi, Mohamad

AU - Esker, Alec

AU - Gordon, Stuart R.

AU - Gress, Frank

AU - Ikenberry, Steven

AU - Joyce, Ann Marie

AU - Klapman, Jason

AU - Lo, Simon

AU - Maluf-Filho, Fauze

AU - Nickl, Nicholas

AU - Singh, Virmeet

AU - Wills, Jason

AU - Behling, Cynthia

PY - 2007/8

Y1 - 2007/8

N2 - Background: The diagnostic yield of EUS-guided FNA (EUS-FNA) of solid pancreatic masses is a potential benchmark for EUS-FNA quality, because the majority of EUS-FNA of solid pancreatic masses should be diagnostic for malignancy. Objectives: To determine the cytologic diagnostic rate of malignancy in EUS-FNA of solid pancreatic masses and to determine if variability exists among endoscopists and centers. Design: Multicenter retrospective study. Patients: EUS centers provided cytology reports for all EUS-FNAs of solid, noncystic, ≥10-mm-diameter, solid pancreatic masses during a 1-year period. Main Outcome Measurement: Cytology diagnostic of pancreatic malignancy. Results: A total of 1075 patients underwent EUS-FNA at 21 centers (81% academic) with 41 endoscopists. The median number of EUS-FNA of solid pancreatic masses performed during the year per center was 46 (range, 4-177) and per endoscopist was 19 (range, 1-97). The mean mass dimensions were 32 × 27 mm, with 73% located in the head. The mean number of passes was 3.5. Of the centers, 90% used immediate cytologic evaluation. The overall diagnostic rate of malignancy was 71%, 95% confidence interval 0.69%-0.74%, with 5% suspicious for malignancy, 6% atypical cells, and 18% negative for malignancy. The median diagnostic rate per center was 78% (range, 39%-93%; 1st quartile, 61%) and per endoscopist was 75% (range, 0%-100%; 1st quartile, 52%). Limitations: Retrospective study, participation bias, and varying chronic pancreatitis prevalence. Conclusions: (1) EUS-FNA cytology was diagnostic of malignancy in 71% of solid pancreatic masses and (2) endoscopists with a final cytologic diagnosis rate of malignancy for EUS-FNA of solid masses that was less than 52% were in the lowest quartile and should evaluate reasons for their low yield.

AB - Background: The diagnostic yield of EUS-guided FNA (EUS-FNA) of solid pancreatic masses is a potential benchmark for EUS-FNA quality, because the majority of EUS-FNA of solid pancreatic masses should be diagnostic for malignancy. Objectives: To determine the cytologic diagnostic rate of malignancy in EUS-FNA of solid pancreatic masses and to determine if variability exists among endoscopists and centers. Design: Multicenter retrospective study. Patients: EUS centers provided cytology reports for all EUS-FNAs of solid, noncystic, ≥10-mm-diameter, solid pancreatic masses during a 1-year period. Main Outcome Measurement: Cytology diagnostic of pancreatic malignancy. Results: A total of 1075 patients underwent EUS-FNA at 21 centers (81% academic) with 41 endoscopists. The median number of EUS-FNA of solid pancreatic masses performed during the year per center was 46 (range, 4-177) and per endoscopist was 19 (range, 1-97). The mean mass dimensions were 32 × 27 mm, with 73% located in the head. The mean number of passes was 3.5. Of the centers, 90% used immediate cytologic evaluation. The overall diagnostic rate of malignancy was 71%, 95% confidence interval 0.69%-0.74%, with 5% suspicious for malignancy, 6% atypical cells, and 18% negative for malignancy. The median diagnostic rate per center was 78% (range, 39%-93%; 1st quartile, 61%) and per endoscopist was 75% (range, 0%-100%; 1st quartile, 52%). Limitations: Retrospective study, participation bias, and varying chronic pancreatitis prevalence. Conclusions: (1) EUS-FNA cytology was diagnostic of malignancy in 71% of solid pancreatic masses and (2) endoscopists with a final cytologic diagnosis rate of malignancy for EUS-FNA of solid masses that was less than 52% were in the lowest quartile and should evaluate reasons for their low yield.

UR - http://www.scopus.com/inward/record.url?scp=34447504769&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=34447504769&partnerID=8YFLogxK

U2 - 10.1016/j.gie.2007.01.017

DO - 10.1016/j.gie.2007.01.017

M3 - Article

VL - 66

SP - 277

EP - 282

JO - Gastrointestinal Endoscopy

JF - Gastrointestinal Endoscopy

SN - 0016-5107

IS - 2

ER -