Optimal number of EUS-guided fine needle passes needed to obtain a correct diagnosis

Julia Kim LeBlanc, Donato Ciaccia, Mohammed T. Al-Assi, Kevin McGrath, Tom Imperiale, Liang Che Tao, Steve Vallery, John DeWitt, Stuart Sherman, Edith Collins

Research output: Contribution to journalArticle

205 Scopus citations


Background: The immediate assistance of a cytologist during EUS-guided FNA is not universal. The optimal number of fine needle passes during EUS-guided FNA has not been determined in a prospective study. The aim of this study was to determine the optimal number of passes required to obtain a correct diagnosis. Methods: Seven or more passes were made with a fine needle into a variety of lesions during EUS-guided FNA. Adequacy of the aspirate, diagnosis, and a "certainty score" were recorded after each pass and interpreted sequentially by a cytopathologist. Surgical histopathology and 1-year clinical follow-up were used as reference standards. The percentage of correctly diagnosed cases was calculated and stratified according to organ, disease group, and EUS characteristics of the lesion. Results: Lesions from 95 patients were categorized into the following locations: pancreas, lymph node, and miscellaneous. The sensitivity and specificity for 7 passes from the pancreas and miscellaneous lesion groups were, respectively, 83% and 100%. The sensitivity and specificity for 5 passes from the lymph node group were, respectively, 77% and 100%. Conclusions: During EUS-guided FNA, at least 7 passes with a fine needle into pancreatic and miscellaneous lesions, and 5 passes into lymph nodes are needed to ensure a high degree of certainty for making a correct diagnosis.

Original languageEnglish (US)
Pages (from-to)475-481
Number of pages7
JournalGastrointestinal endoscopy
Issue number4
StatePublished - Apr 1 2004
Externally publishedYes

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

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