Contrast-Enhanced Harmonic Endoscopic Ultrasound-Guided Fine-Needle Aspiration versus Standard Fine-Needle Aspiration in Pancreatic Masses: A Propensity Score Analysis

• Main Authors: Antonio Facciorusso, Christian Cotsoglou, Andrea Chierici, Ruxandra Mare, Stefano Francesco Crinò, Nicola Muscatiello
• Format: Article
• Language: English
• Published: MDPI AG 2020-10-01
• Series: Diagnostics
• Subjects: endoscopic ultrasound (EUS); fine-needle aspiration (FNA); pancreas; endoscopy; contrast-enhanced fine-needle aspiration (CH-FNA).
• Online Access: https://www.mdpi.com/2075-4418/10/10/792

Background: Whether endoscopic ultrasound (EUS) contrast-enhanced fine-needle aspiration (CH-EUS-FNA) determines superior results in comparison to standard EUS-FNA in tissue acquisition of pancreatic masses remains unclear. The aim of this study was to compare these two techniques on a series of patients with solid pancreatic lesions. Methods: 362 patients underwent EUS-FNA (2008–2019), after the propensity score matching of two groups were compared; 103 treated with CH-EUS-FNA (group 1) and 103 with standard EUS-FNA (group 2). The primary outcome was the diagnostic accuracy. Secondary outcomes were sensitivity, specificity, and sample adequacy. Results: Diagnostic sensitivity was 87.6% in group 1 and 80% in group 2 (<i>p </i>= 0.18). The negative predictive value was 56% in group 1 and 41.5% in group 2 (<i>p </i>= 0.06). The specificity and positive predictive values were 100% for both groups. Diagnostic accuracy was 89.3% and 82.5%, respectively (<i>p </i>= 0.40). Sample adequacy was 94.1% in group 1 and 91.2% in group 2 (<i>p </i>= 0.42). The rate of adequate core histologic samples was 33% and 28.1%, respectively (<i>p </i>= 0.44), and the number of needle passes to obtain adequate samples were 2.4 ± 0.6 and 2.7 ± 0.8, respectively (<i>p </i>= 0.76). These findings were confirmed in subgroup analyses, conducted according to lesion size and contrast enhancement pattern. Conclusions: CH-EUS-FNA does not appear to be superior to standard EUS-FNA in patients with pancreatic masses.