Background and study aims: The overall diagnostic accuracy of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) for subepithelial lesions (SELs) is suboptimal. The aim of this study was to evaluate the diagnostic accuracy, defined as the proportion of correct diagnoses, obtained using the EUS-guided fine-needle tissue acquisition (FNTA) sampling technique performed with the newly developed forward-viewing EUS scope (FV-EUS). Patients and methods: This was a retrospective analysis of a prospectively collected database including all consecutive patients with SELs who underwent EUS-FNTA using the FV-EUS scope from 2007 to 2011 in a tertiary referral center. All procedures were performed by a single expert endoscopist. Results: A total of 121 consecutive patients with SELs (13 in the esophagus, 96 in the stomach, 10 in the duodenum, 2 in the rectum) underwent sampling of the lesion using the FV-EUS scope. The procedure was technically feasible in all but one patient, and no complication related to EUS-FNTA occurred. Full histological assessment including immunostaining could be completed in 93.4% (113/121) of the patients. Considering neoplastic vs. non-neoplastic diseases, the sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio were 92.8% (95%CI 86.3-96.8), 100% (95%CI 69.0-100%), infinity, and 0.07 (95%CI 0.04-0.14), respectively. Conclusions: EUS-FNTA performed in conjunction with the FV-EUS scope for sampling SELs of the gastrointestinal tract was safe and provided a very high diagnostic accuracy. Studies comparing FV-EUS with standard curved linear echoendoscopes are needed to clarify whether these results are due to the sampling technique or the type of scope utilized.

Fine-needle tissue acquisition from subepithelial lesions using a forward-viewing linear echoendoscope / Larghi, Alberto; Fuccio, Lorenzo; Chiarello, Gaia; Attili, Fabia; Vanella, Giuseppe; Paliani, Giovanni Battista; Napoleone, Matteo; Rindi, Guido; Larocca, Luigi Maria; Costamagna, Guido; Ricci, Riccardo. - In: ENDOSCOPY. - ISSN 0013-726X. - 46:1(2014), pp. 39-45. [10.1055/s-0033-1344895]

Fine-needle tissue acquisition from subepithelial lesions using a forward-viewing linear echoendoscope

Attili, Fabia;Vanella, Giuseppe;Ricci, Riccardo
2014

Abstract

Background and study aims: The overall diagnostic accuracy of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) for subepithelial lesions (SELs) is suboptimal. The aim of this study was to evaluate the diagnostic accuracy, defined as the proportion of correct diagnoses, obtained using the EUS-guided fine-needle tissue acquisition (FNTA) sampling technique performed with the newly developed forward-viewing EUS scope (FV-EUS). Patients and methods: This was a retrospective analysis of a prospectively collected database including all consecutive patients with SELs who underwent EUS-FNTA using the FV-EUS scope from 2007 to 2011 in a tertiary referral center. All procedures were performed by a single expert endoscopist. Results: A total of 121 consecutive patients with SELs (13 in the esophagus, 96 in the stomach, 10 in the duodenum, 2 in the rectum) underwent sampling of the lesion using the FV-EUS scope. The procedure was technically feasible in all but one patient, and no complication related to EUS-FNTA occurred. Full histological assessment including immunostaining could be completed in 93.4% (113/121) of the patients. Considering neoplastic vs. non-neoplastic diseases, the sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio were 92.8% (95%CI 86.3-96.8), 100% (95%CI 69.0-100%), infinity, and 0.07 (95%CI 0.04-0.14), respectively. Conclusions: EUS-FNTA performed in conjunction with the FV-EUS scope for sampling SELs of the gastrointestinal tract was safe and provided a very high diagnostic accuracy. Studies comparing FV-EUS with standard curved linear echoendoscopes are needed to clarify whether these results are due to the sampling technique or the type of scope utilized.
Endoscopic Ultrasound-Guided Fine Needle Aspiration; Endosonography; Gastrointestinal Neoplasms; Gastrointestinal Stromal Tumors; Leiomyoma; Predictive Value of Tests; Retrospective Studies; Gastroenterology
01 Pubblicazione su rivista::01a Articolo in rivista
Fine-needle tissue acquisition from subepithelial lesions using a forward-viewing linear echoendoscope / Larghi, Alberto; Fuccio, Lorenzo; Chiarello, Gaia; Attili, Fabia; Vanella, Giuseppe; Paliani, Giovanni Battista; Napoleone, Matteo; Rindi, Guido; Larocca, Luigi Maria; Costamagna, Guido; Ricci, Riccardo. - In: ENDOSCOPY. - ISSN 0013-726X. - 46:1(2014), pp. 39-45. [10.1055/s-0033-1344895]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1122914
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