Comparison of the diagnostic yield of rapid versus non-rapid onsite evaluation in endoscopic ultrasound-guided fine-needle aspiration cytology of solid pancreatic lesions

Rajeeb Jaleel; John Titus George; Ajith Thomas; Lalji Patel; Anoop John; Reuben Thomas Kurien; Ebby George Simon; A. J. Joseph; Amit Kumar Dutta; Sudipta Dhar Chowdhury

Authors Rajeeb Jaleel, John Titus George, Ajith Thomas, Lalji Patel, Anoop John, Reuben Thomas Kurien, Ebby George Simon, A. J. Joseph, Amit Kumar Dutta, Sudipta Dhar Chowdhury.

Abstract

Background The role of rapid on-site evaluation (ROSE) for endoscopic ultrasound-guided fineneedle aspiration (EUS-FNA) of pancreatic lesions is debatable. In this study, we aimed to compare the diagnostic yield of ROSE vs. non-ROSE in solid pancreatic lesions.

Methods This retrospective single-center study included patients undergoing EUS-FNA of solid pancreatic lesions from 2019-2021. Patients with cystic lesions, those undergoing fine-needle core biopsy, those undergoing repeat procedures, and patients with non-diagnostic smears with less than 6-month follow up were excluded. The diagnostic yield, need for repeat procedures and number of passes required with and without ROSE were analyzed in these patients.

Results Of the 111 patients included, 56 underwent ROSE. The majority of lesions were malignant in both groups (79.6% ROSE vs. 75% non-ROSE). The diagnostic yield was 96.4% in the ROSE group and 94.5% in the non-ROSE group. Repeat samples were needed in 1 ROSE and 2 non- ROSE patients. The median number of passes made was significantly fewer in the ROSE group (3.5, interquartile range - 3,4) compared with the non-ROSE group (4, interquartile range - 3,5) P=0.01. However, the frequency of procedure-related complications was similar in both groups.

Conclusion The utilization of ROSE during EUS-FNA of solid pancreatic lesions does not affect the diagnostic yield or the need for repeat samples, but reduces the number of passes needed for acquiring samples.

Keywords Endoscopic ultrasound-guided fine-needle aspiration, rapid on-site evaluation, diagnostic yield, cellularity of smears

Ann Gastroenterol 2024; 37 (3): 371-376