Endoscopic ultrasound-guided tissue acquisition with or without macroscopic on-site evaluation: Randomized controlled trial
Background The use of macroscopic on-site evaluation (MOSE) to estimate the adequacy of a specimen for histological diagnosis during endoscopic ultrasound (EUS)-guided fine-needle tissue acquisition (FNTA) has recently been advocated. This study aimed to evaluate the diagnostic yield of MOSE compare...
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2020
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my.um.eprints.363532023-11-30T03:09:04Z http://eprints.um.edu.my/36353/ Endoscopic ultrasound-guided tissue acquisition with or without macroscopic on-site evaluation: Randomized controlled trial Chong, Charing C. N. Lakhtakia, Sundeep Nguyen, Nam Hara, Kazuo Chan, Wah Kheong Puri, Rajesh Almadi, Majid A. Ang, Tiing Leong Kwek, Andrew Yasuda, Ichiro Doi, Shinpei Kida, Mitsuhiro Wang, Hsiu-Po Cheng, Tsu-Yao Jiang, Qingwei Yang, Aiming Chan, Anthony W. H. Chan, Shannon Tang, Raymond Iwashita, Takuji Teoh, Anthony Y. B. R Medicine RA0421 Public health. Hygiene. Preventive Medicine Background The use of macroscopic on-site evaluation (MOSE) to estimate the adequacy of a specimen for histological diagnosis during endoscopic ultrasound (EUS)-guided fine-needle tissue acquisition (FNTA) has recently been advocated. This study aimed to evaluate the diagnostic yield of MOSE compared with conventional EUS-FNTA without rapid on-site evaluation (ROSE). Methods This was an international, multicenter, prospective, randomized controlled study. After providing informed consent, consecutive adult patients referred for EUS-FNTA for solid lesions larger than 2cm were randomized to a MOSE arm or to a conventional arm without ROSE. A designated cytopathologist from each center performed all cytopathological examinations for that center and was blinded to the randomization results. The primary outcome measure was the diagnostic yield, and the secondary outcomes included sensitivity, specificity, positive predictive value, negative predictive value, diagnostic accuracy, and the rate of procedure-related complications. Results 244 patients (122 conventional, 122 MOSE) were enrolled during the study period. No significant differences between the two arms were found in procedure time or rate of procedure-related adverse events. The diagnostic yield for the MOSE technique (92.6%) was similar to that for the conventional technique (89.3%; P =0.37), with significantly fewer passes made (median: conventional 3, MOSE 2; P <0.001). Conclusions EUS-FNTA with the MOSE technique provided a similar diagnostic yield to conventional EUS-FNTA technique in the absence of ROSE but with fewer passes. This technique can be used when ROSE is not available. Georg Thieme Verlag Kg 2020-10 Article PeerReviewed Chong, Charing C. N. and Lakhtakia, Sundeep and Nguyen, Nam and Hara, Kazuo and Chan, Wah Kheong and Puri, Rajesh and Almadi, Majid A. and Ang, Tiing Leong and Kwek, Andrew and Yasuda, Ichiro and Doi, Shinpei and Kida, Mitsuhiro and Wang, Hsiu-Po and Cheng, Tsu-Yao and Jiang, Qingwei and Yang, Aiming and Chan, Anthony W. H. and Chan, Shannon and Tang, Raymond and Iwashita, Takuji and Teoh, Anthony Y. B. (2020) Endoscopic ultrasound-guided tissue acquisition with or without macroscopic on-site evaluation: Randomized controlled trial. Endoscopy, 52 (10). pp. 856-863. ISSN 0013-726X, DOI https://doi.org/10.1055/a-1172-6027 <https://doi.org/10.1055/a-1172-6027>. 10.1055/a-1172-6027 |
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R Medicine RA0421 Public health. Hygiene. Preventive Medicine Chong, Charing C. N. Lakhtakia, Sundeep Nguyen, Nam Hara, Kazuo Chan, Wah Kheong Puri, Rajesh Almadi, Majid A. Ang, Tiing Leong Kwek, Andrew Yasuda, Ichiro Doi, Shinpei Kida, Mitsuhiro Wang, Hsiu-Po Cheng, Tsu-Yao Jiang, Qingwei Yang, Aiming Chan, Anthony W. H. Chan, Shannon Tang, Raymond Iwashita, Takuji Teoh, Anthony Y. B. Endoscopic ultrasound-guided tissue acquisition with or without macroscopic on-site evaluation: Randomized controlled trial |
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Background The use of macroscopic on-site evaluation (MOSE) to estimate the adequacy of a specimen for histological diagnosis during endoscopic ultrasound (EUS)-guided fine-needle tissue acquisition (FNTA) has recently been advocated. This study aimed to evaluate the diagnostic yield of MOSE compared with conventional EUS-FNTA without rapid on-site evaluation (ROSE). Methods This was an international, multicenter, prospective, randomized controlled study. After providing informed consent, consecutive adult patients referred for EUS-FNTA for solid lesions larger than 2cm were randomized to a MOSE arm or to a conventional arm without ROSE. A designated cytopathologist from each center performed all cytopathological examinations for that center and was blinded to the randomization results. The primary outcome measure was the diagnostic yield, and the secondary outcomes included sensitivity, specificity, positive predictive value, negative predictive value, diagnostic accuracy, and the rate of procedure-related complications. Results 244 patients (122 conventional, 122 MOSE) were enrolled during the study period. No significant differences between the two arms were found in procedure time or rate of procedure-related adverse events. The diagnostic yield for the MOSE technique (92.6%) was similar to that for the conventional technique (89.3%; P =0.37), with significantly fewer passes made (median: conventional 3, MOSE 2; P <0.001). Conclusions EUS-FNTA with the MOSE technique provided a similar diagnostic yield to conventional EUS-FNTA technique in the absence of ROSE but with fewer passes. This technique can be used when ROSE is not available. |
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Article |
| author |
Chong, Charing C. N. Lakhtakia, Sundeep Nguyen, Nam Hara, Kazuo Chan, Wah Kheong Puri, Rajesh Almadi, Majid A. Ang, Tiing Leong Kwek, Andrew Yasuda, Ichiro Doi, Shinpei Kida, Mitsuhiro Wang, Hsiu-Po Cheng, Tsu-Yao Jiang, Qingwei Yang, Aiming Chan, Anthony W. H. Chan, Shannon Tang, Raymond Iwashita, Takuji Teoh, Anthony Y. B. |
| author_facet |
Chong, Charing C. N. Lakhtakia, Sundeep Nguyen, Nam Hara, Kazuo Chan, Wah Kheong Puri, Rajesh Almadi, Majid A. Ang, Tiing Leong Kwek, Andrew Yasuda, Ichiro Doi, Shinpei Kida, Mitsuhiro Wang, Hsiu-Po Cheng, Tsu-Yao Jiang, Qingwei Yang, Aiming Chan, Anthony W. H. Chan, Shannon Tang, Raymond Iwashita, Takuji Teoh, Anthony Y. B. |
| author_sort |
Chong, Charing C. N. |
| title |
Endoscopic ultrasound-guided tissue acquisition with or without macroscopic on-site evaluation: Randomized controlled trial |
| title_short |
Endoscopic ultrasound-guided tissue acquisition with or without macroscopic on-site evaluation: Randomized controlled trial |
| title_full |
Endoscopic ultrasound-guided tissue acquisition with or without macroscopic on-site evaluation: Randomized controlled trial |
| title_fullStr |
Endoscopic ultrasound-guided tissue acquisition with or without macroscopic on-site evaluation: Randomized controlled trial |
| title_full_unstemmed |
Endoscopic ultrasound-guided tissue acquisition with or without macroscopic on-site evaluation: Randomized controlled trial |
| title_sort |
endoscopic ultrasound-guided tissue acquisition with or without macroscopic on-site evaluation: randomized controlled trial |
| publisher |
Georg Thieme Verlag Kg |
| publishDate |
2020 |
| url |
http://eprints.um.edu.my/36353/ |
| _version_ |
1784511813959811072 |
| score |
13.211869 |