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Pancreas
PMO-108 Diagnosis of pancreatic solid lesions with EUS and FNA: a report of accuracy
  1. S R Kadri,
  2. K Law,
  3. M James,
  4. K Ragunath,
  5. G Aithal
  1. Department of Gastroenterology, Nottingham University Hospital, Nottingham, UK

Abstract

Introduction Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is an accurate method for cytological confirmation of pancreatic lesions, but it is unclear whether its diagnostic accuracy is affected by it's size, location, or size of needles used for biopsy. Our aim was to investigate the accuracy of EUS-FNA for suspected pancreatic lesions in relation to these factors, especially to the size of lesions, size of the needle used for biopsy and number of passes.

Methods In this tertiary referral centre, EUS-FNAs for 186 solid pancreatic lesions from 1 April 2010 to 31 March 2011 were evaluated retrospectively. Size of the lesion, site of the lesions were obtained as well as the information on size of the needle used to take biopsy and number of passes made and adequacy of the sample obtained.

Results 87 males and 85 females had 186 EUS FNA for solid pancreatic lesions.71% (123/172) of then were aged between 51 and 80 years. 79 lesions were in the head of the pancreas alone. Information on adequacies for sampling was available for 149 procedures. Overall adequacy of EUS-FNA sampling was 76% (114/149). Adequacy for the sample for lesions <10 mm was 77% (10/13) and for more than 10mm was 68% (104/153); those for lesions in the head was 70% (55/79) and for rest of the pancreas was 75% (59/79). Success rate for single, two, three and four passes made to obtain sample were 58%, 75%, 70% and 80% respectively. Accuracies for 19, 22 and 25-gauge needle sampling were 67%, 76% and 85% respectively.

Conclusion EUS-FNA has high accuracy in the evaluation of suspected pancreatic lesions regardless of its size, location of the lesion. It was useful also in confirming small pancreatic lesions that were <10 mm. 25-gauge needle produced best tissue yield out of all the types of the needles used for sampling.

Competing interests None declared.

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