Rapid on-site evaluation for endoscopic ultrasound-guided fine-needle biopsy of the pancreas decreases the incidence of repeat biopsy procedures

Authors

  • Brian T. Collins MD,

    Corresponding author
    1. Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri
    • Corresponding author: Brian T. Collins, MD, Department of Pathology and Immunology, Washington University School of Medicine, Campus Box 8118, 660 South Euclid Ave, St. Louis, MO 63110-1093; Fax: (314) 747-2663; bcollins@path.wustl.edu

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  • Faris M. Murad MD,

    1. Division of Gastroenterology and Interventional Endoscopy, Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri
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  • Jeff F. Wang MD,

    1. Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri
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  • Cory T. Bernadt MD, PhD

    1. Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri
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Abstract

BACKGROUND

Rapid on-site evaluation (ROSE) for endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) biopsy of the pancreas provides immediate feedback regarding cellular adequacy to aid in obtaining a definitive diagnosis and has the potential to avoid repeat procedures. The objective of the current study was to measure the impact of ROSE service on the incidence of repeat EUS FNA biopsy procedures.

METHODS

Over a consecutive 3-year period, the pathology database at Washington University Medical Center was searched for patients with both an initial and subsequent EUS FNA biopsy demonstrating a solid lesion of the pancreas. These were divided temporally between the time before and after the introduction of ROSE service. Reports were reviewed and results were recorded.

RESULTS

A total of 379 patients underwent ROSE service and 377 patients did not. The percentage of repeat non-ROSE EUS FNA cases was 5.8% and the percentage of repeat ROSE EUS FNA cases was 2.9%. The use of the ROSE service was found to decrease the number of repeat procedures by approximately 50% (P = .024). For those patients who underwent a repeat EUS-FNA procedure, the ROSE service provided a higher rate of definitive diagnosis among patients undergoing repeat procedures (67%) versus the non-ROSE cohort (27%).

CONCLUSIONS

The use of ROSE for EUS-FNA biopsy of the pancreas was found to result in fewer patients undergoing repeat procedures. Patients who required a repeat procedure with the use of ROSE had a higher percentage of definitive diagnostic categorization on the repeat biopsy. Initial use of ROSE for EUS-FNA of solid pancreatic lesions was found to decrease the number of patients who required a repeat procedure. Cancer (Cancer Cytopathol) 2013;121:518–24. © 2013 American Cancer Society.

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