Fine-needle aspiration of pancreatic cystic lesions: a randomized study with long-term follow-up comparing standard and flexible needles.

Endoscopy
Mohammad Al-HaddadDouglas O Faigel

Abstract

Pancreatic cystic lesions (PCLs) are increasingly found on cross-sectional imaging, with the majority having a low risk for malignancy. The added value of fine-needle aspiration (FNA) in risk stratification remains unclear. We evaluated the impact of three FNA needles on diagnostic accuracy, clinical management, and the ability to accrue fluid for tumor markers. A multicenter prospective trial randomized 250 patients with PCLs ≥ 13 mm 2:1:1 to 19G Flex, 19G, and 22G needles with crossover for repeated FNA procedures. Diagnostic accuracy was established at 2-year follow-up, with the final diagnosis from surgical histopathology or consensus diagnosis by experts based sequentially on clinical presentation, imaging, and aspirate analysis in blinded review. Enrolled patients (36 % symptomatic) had PCLs in the head (44 %), body (28 %), and tail (26 %). Percentage of cyst volume aspirated was 78 % (72 % - 84 %) for 19G Flex, 74 % (64 % - 84 %) for 22G, and 73 % (63 % - 83 %) for 19G (P = 0.84). Successful FNA was significantly higher for 19G Flex (89 % [82 % - 94 %]) and 22G (82 % [70 % - 90 %]) compared with 19G (75 % [63 % - 85 %]) (P = 0.02). Repeated FNA was required more frequently in head/uncinate lesions than in body and tail (...Continue Reading

Associated Clinical Trials

References

May 8, 2004·Gastroenterology·William R BruggeAndrew L Warshaw
Jan 21, 2009·Gastrointestinal Endoscopy·Asif KhalidKevin M McGrath
Mar 2, 2010·Gastrointestinal Endoscopy·Peter B CottonJohn J Vargo
Jun 13, 2012·Pancreatology : Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]·Masao TanakaUNKNOWN International Association of Pancreatology
Feb 19, 2013·Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver·Marco Del ChiaroUNKNOWN European Study Group on Cystic Tumours of the Pancreas
Mar 26, 2015·Gastroenterology·Santhi Swaroop VegeUNKNOWN American Gastroenterology Association
Apr 15, 2015·Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver·Maria MorisMichael B Wallace
Sep 16, 2015·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Maria MorisMichael B Wallace
May 22, 2016·Gastrointestinal Endoscopy·UNKNOWN ASGE Standards of Practice CommitteeJohn M DeWitt
Oct 4, 2016·Gastrointestinal Endoscopy·Selma J LekkerkerkerJeanin E van Hooft
Jan 6, 2017·CA: a Cancer Journal for Clinicians·Rebecca L SiegelAhmedin Jemal
Jan 25, 2017·Digestive Diseases and Sciences·Michael SighinolfiWalter G Park
Feb 22, 2017·Digestive Endoscopy : Official Journal of the Japan Gastroenterological Endoscopy Society·Huiyun ZhuZhaoshen Li
Jul 25, 2017·Pancreatology : Official Journal of the International Association of Pancreatology (IAP) ... [et Al.]·Masao TanakaChristopher L Wolfgang
Feb 28, 2018·The American Journal of Gastroenterology·Grace H EltaAnne Marie Lennon
May 7, 2020·Journal of the American College of Radiology : JACR·UNKNOWN Expert Panel on Gastrointestinal ImagingLaura R Carucci

❮ Previous
Next ❯

Citations

Aug 27, 2021·Endoscopy·Mohammad Al-Haddad, Michael B Wallace

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.