Ultrasound-guided percutaneous fine-needle aspiration of solid pancreatic neoplasms: 10-year experience with more than 2,000 cases and a review of the literature

• Published in: European radiology Vol. 26; no. 6; pp. 1801 - 1807
• Main Authors: D’Onofrio, Mirko, De Robertis, Riccardo, Barbi, Emilio, Martone, Enrico, Manfrin, Erminia, Gobbo, Stefano, Puntel, Gino, Bonetti, Franco, Pozzi Mucelli, Roberto
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.06.2016; Springer Nature B.V
• Subjects: Accuracy; Adult; Aged; Aged, 80 and over; Biopsy, Fine-Needle - adverse effects; Biopsy, Fine-Needle - methods; Diagnostic Radiology; Endoscopy; False Negative Reactions; Female; Follow-Up Studies; Hepatobiliary-Pancreas; Humans; Imaging; Internal Medicine; Interventional Radiology; Literature reviews; Lymphoma; Magnetic resonance imaging; Male; Medicine; Medicine & Public Health; Metastasis; Middle Aged; Neuroradiology; Pancreatic Neoplasms - diagnosis; Pancreatic Neoplasms - diagnostic imaging; Pancreatic Neoplasms - pathology; Pathology; Patients; Prognosis; Radiology; Retrospective Studies; Sensitivity and Specificity; Tumors; Ultrasonic imaging; Ultrasonography, Interventional - adverse effects; Ultrasonography, Interventional - methods; Ultrasound; Young Adult; United States > US; Italy; Fine-needle aspiration; Pancreas; Ultrasound; Neoplasms; Cytology
• ISSN: 0938-7994; 1432-1084
• DOI: 10.1007/s00330-015-4003-x

Objectives To evaluate the diagnostic accuracy and complication rate of percutaneous ultrasound-guided fine-needle aspiration (US-FNA) of solid pancreatic neoplasms through the analysis of 10-year experiences of two centres. Methods Clinical, radiological and pathologic data of 2,024 patients with solid pancreatic masses who underwent US-FNAs were retrospectively evaluated. Indications for aspiration were: unresectable lesions before neo-adjuvant therapy; doubtful imaging findings; and suspicion of uncommon neoplasms with prognostic or therapeutic implications such as metastases or lymphoma. US-FNAs were performed using aspiration needles with a cytopathologist present in centre 1. In centre 2, cytologic samples were collected with Chiba needles and separately evaluated by a cytopathologist. Results US-FNA had a diagnostic sample rate of 92.2 % (centre 1: 95.9 %; centre 2: 87.2 %). US-FNA repetition after non-diagnostic samples provided a diagnosis in 86.3 % of cases. Sensitivity, specificity, positive and negative predictive values, and accuracy were 98.7 %, 100 %, 100 %, 75.5 %, and 98.7 %, respectively. The complication rate was 0.8 %. Conclusions Percutaneous US-FNA is a sensitive, accurate and safe method for the invasive diagnosis of solid pancreatic neoplasms. The use of aspiration needles and the on-site presence of a cytopathologist may lead to a high rate of diagnostic samples, thus reducing the need for US-FNA repetition. Key Points • Percutaneous ultrasound-guided fine-needle aspiration of pancreatic neoplasms is sensitive and accurate. • The short-term complication rate of percutaneous ultrasound-guided fine-needle aspiration is low. • Technical aspects may influence the rate of diagnostic samples.