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Agreement on endoscopic ultrasonography-guided tissue specimens: Comparing a 20-G fine-needle biopsy to a 25-G fine-needle aspiration needle among academic and non-academic pathologists.

  • Author(s): van Riet, Priscilla A;
  • Cahen, Djuna L;
  • Biermann, Katharina;
  • Hansen, Bettina;
  • Larghi, Alberto;
  • Rindi, Guido;
  • Fellegara, Giovanni;
  • Arcidiacono, Paolo;
  • Doglioni, Claudio;
  • Liberta Decarli, Nicola;
  • Iglesias-Garcia, Julio;
  • Abdulkader, Ihab;
  • Lazare Iglesias, Hector;
  • Kitano, Masayuki;
  • Chikugo, Takaaki;
  • Yasukawa, Satoru;
  • van der Valk, Hans;
  • Nguyen, Nam Quoc;
  • Ruszkiewicz, Andrew;
  • Giovannini, Marc;
  • Poizat, Flora;
  • van der Merwe, Schalk;
  • Roskams, Tania;
  • Santo, Erwin;
  • Marmor, Silvia;
  • Chang, Kenneth;
  • Lin, Fritz;
  • Farrell, James;
  • Robert, Marie;
  • Bucobo, Juan Carlos;
  • Heimann, Alan;
  • Baldaque-Silva, Francisco;
  • Fernández Moro, Carlos;
  • Bruno, Marco J
  • et al.

Published Web Location

https://doi.org/10.1111/den.13424Creative Commons 'BY' version 4.0 license
Abstract

Background and aim

A recently carried out randomized controlled trial showed the benefit of a novel 20-G fine-needle biopsy (FNB) over a 25-G fine-needle aspiration (FNA) needle. The current study evaluated the reproducibility of these findings among expert academic and non-academic pathologists.

Methods

This study was a side-study of the ASPRO (ASpiration versus PROcore) study. Five centers retrieved 74 (59%) consecutive FNB and 51 (41%) FNA samples from the ASPRO study according to randomization; 64 (51%) pancreatic and 61 (49%) lymph node specimens. Samples were re-reviewed by five expert academic and five non-academic pathologists and rated in terms of sample quality and diagnosis. Ratings were compared between needles, expert academic and non-academic pathologists, target lesions, and cytology versus histological specimens.

Results

Besides a higher diagnostic accuracy, FNB also provided for a better agreement on diagnosing malignancy (ĸ = 0.59 vs ĸ = 0.76, P < 0.001) and classification according to Bethesda (ĸ = 0.45 vs ĸ = 0.61, P < 0.001). This equally applied for expert academic and non-academic pathologists and for pancreatic and lymph node specimens. Sample quality was also rated higher for FNB, but agreement ranged from poor (ĸ = 0.04) to fair (ĸ = 0.55). Histology provided better agreement than cytology, but only when a core specimen was obtained with FNB (P = 0.004 vs P = 0.432).

Conclusion

This study shows that the 20-G FNB outperforms the 25-G FNA needle in terms of diagnostic agreement, independent of the background and experience of the pathologist. This endorses use of the 20-G FNB needle in both expert and lower volume EUS centers.

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