Accuracy and Quality Assessment of EUS-FNA : A Single-Center Large Cohort of Biopsies

Abstract EN

Introduction.

Thorough quality control (QC) study with systemic monitoring and evaluation is crucial to optimizing the effectiveness of EUS-FNA.

Methods.

Retrospective analysis was composed of investigating consecutive patient files that underwent EUS-FNA.

QC specifically focused on diagnostic accuracy, impacts on preexisting diagnoses, and case management.

Results.

268 patient files were evaluated.

EUS-FNA cytology helped establish accurate diagnoses in 92.54% (248/268) of patients.

Sensitivity, specificity, PPV, NPV, and accuracy were 83%, 100%, 100%, 91.6%, and 94%, respectively.

The most common biopsy site was the pancreas (68%).

The most accurate location for EUS-FNA was the esophagus, 13/13 (100%), followed by the pancreas (89.6%).

EUS-FNA was least informative for abdominal lymph nodes (70.5%).

After FNA and followup, eight false negatives for tumors were found (3%), while 7.5% of samples still lacked a definitive diagnosis.

Discussion.

QC suggests that the diagnostic accuracy of EUS-FNA might be improved further by (1) taking more FNA passes from suspected lesions, (2) optimizing needle selection (3) having an experienced echo-endoscopist available during the learning curve, and (4) having a cytologist present during the procedure.

QC also identified remediable reporting errors.

In conclusion, QC study is valuable in identifying weaknesses and thereby augmenting the effectiveness of EUS-FNA.