ScholarLens Back to search
2021•EndoscopyRequires access

Contrast-Enhanced Harmonic Endoscopic Ultrasound (CH-EUS)-Guided Fine-Needle Aspiration Versus Standard Fine-Needle Aspiration In Pancreatic Masses: A Meta-Analysis

Antonio Facciorusso, Mohan Bp, SF Crinò, Andrew Ofosu, Daryl Ramai, Andrea Lisotti, Saurabh Chandan, Pietro Fusaroli

Open publisher page 3 citations

Abstract

Aims It is still unclear whether endoscopic ultrasound (EUS) contrast-enhanced Harmonic fine-needle aspiration (CH-EUS-FNA) determines superior results in comparison to standard EUS-FNA in tissue acquisition of pancreatic masses. The aim was to compare the pooled diagnostic performances of these two techniques. Methods A systematic electronic search through PubMed/Medline and Embase database at the end of October 2020 was performed; all original articles dealing with the comparison of the diagnostic performance between CH-EUS-FNA and EUS-FNA were included. The primary outcome was diagnostic sensitivity; secondary outcomes included specificity, accuracy, sample adequacy, and number of needle passes. We performed pairwise meta-analysis through a random effects model and expressed data as odds ratio (OR) and 95 % confidence interval (CI). Results Six studies (2 randomized controlled trials) have been identified; study outcomes were reported in the [ table ]. Pooled diagnostic sensitivity was 84.6 % (95 % CI 80.7-88.6 %) with CH-EUS-FNA and 75.3 % (67.0-83.5 %) with EUS-FNA, with evidence of a significant superiority of the former (OR 1.74, 95 % CI 1.26-2.40; p<0.001). Subgroup analysis confirmed the superiority of CH-EUS-FNA over EUS-FNA only in larger lesions (OR 2,38, 1.33-4.25 with the cut-off of 1.5 cm and OR 2.18, 1.12-3.01 with the cut-off of 2 cm). Pooled diagnostic sensitivity of CH-EUS-FNA was 86.2 % (79.7-92.7 %) in hypoenhanced and 89.4 % (82.8-96.0 %) in iso/hyperenhanced lesions (p=0.23). Pooled diagnostic accuracy was 88.8 % (85.6-91.9 %) in CH-EUS-FNA group and 83.6 % (79.4-87.8 %) in EUS-FNA group (OR 1.52, 1.01-2.31; p=0.05). Pooled sample adequacy was 95.1 % (91.1-99.1 %) with CH-EUS-FNA and 89.4 % (81.0-97.8 %) with EUS-FNA (OR 2.40, 1.38-4.17; p = 0.02). No difference in terms of number of needle passes was observed (mean difference: -0.10, -0.28 to 0.08; p = 0.29). Tab. 1 No of studies analyzed No. in CH-EUS-FNA group No. in EUS-FNA group

About this research paper

What this paper is about

Aims It is still unclear whether endoscopic ultrasound (EUS) contrast-enhanced Harmonic fine-needle aspiration (CH-EUS-FNA) determines superior results in comparison to standard EUS-FNA in tissue acquisition of pancreatic masses. The aim was to compare the pooled diagnostic performances of these two techniques. Methods A systematic electronic search through PubMed/Medline and Embase database at the end of October 2020 was performed; all original articles dealing with the comparison of the diagnostic performance between CH-EUS-FNA and EUS-FNA were included. The primary outcome was diagnostic sensitivity; secondary outcomes included specificity, accuracy, sample adequacy, and number of needle passes. We performed pairwise meta-analysis through a random effects model and expressed data as odds ratio (OR) and 95 % confidence interval (CI). Results Six studies (2 randomized controlled trials) have been identified; study outcomes were reported in the [ table ]. Pooled diagnostic sensitivity was 84.6 % (95 % CI 80.7-88.6 %) with CH-EUS-FNA and 75.3 % (67.0-83.5 %) with EUS-FNA, with evidence of a significant superiority of the former (OR 1.74, 95 % CI 1.26-2.40; p<0.001). Subgroup analysis confirmed the superiority of CH-EUS-FNA over EUS-FNA only in larger lesions (OR 2,38, 1.33-4.25 with the cut-off of 1.5 cm and OR 2.18, 1.12-3.01 with the cut-off of 2 cm). Pooled diagnostic sensitivity of CH-EUS-FNA was 86.2 % (79.7-92.7 %) in hypoenhanced and 89.4 % (82.8-96.0 %) in iso/hyperenhanced lesions (p=0.23). Pooled diagnostic accuracy was 88.8 % (85.6-91.9 %) in CH-EUS-FNA group and 83.6 % (79.4-87.8 %) in EUS-FNA group (OR 1.52, 1.01-2.31; p=0.05). Pooled sample adequacy was 95.1 % (91.1-99.1 %) with CH-EUS-FNA and 89.4 % (81.0-97.8 %) with EUS-FNA (OR 2.40, 1.38-4.17; p = 0.02). No difference in terms of number of needle passes was observed (mean difference: -0.10, -0.28 to 0.08; p = 0.29). Tab. 1 No of studies analyzed No. in CH-EUS-FNA group No. in EUS-FNA group

Why it matters

OpenAlex reports 3 citations for this work. Citation counts describe recorded attention and do not establish research quality.

Key contribution

A contribution statement is not available in the OpenAlex record.

Method / approach

Method details are not available in the OpenAlex metadata.

Main findings

Findings are not separately available in the OpenAlex metadata.

Limitations

Limitations are not available in the OpenAlex metadata.

Applications

Application details are not available in the OpenAlex metadata.

Available abstract

Aims It is still unclear whether endoscopic ultrasound (EUS) contrast-enhanced Harmonic fine-needle aspiration (CH-EUS-FNA) determines superior results in comparison to standard EUS-FNA in tissue acquisition of pancreatic masses. The aim was to compare the pooled diagnostic performances of these two techniques. Methods A systematic electronic search through PubMed/Medline and Embase database at the end of October 2020 was performed; all original articles dealing with the comparison of the diagnostic performance between CH-EUS-FNA and EUS-FNA were included. The primary outcome was diagnostic sensitivity; secondary outcomes included specificity, accuracy, sample adequacy, and number of needle passes. We performed pairwise meta-analysis through a random effects model and expressed data as odds ratio (OR) and 95 % confidence interval (CI). Results Six studies (2 randomized controlled trials) have been identified; study outcomes were reported in the [ table ]. Pooled diagnostic sensitivity was 84.6 % (95 % CI 80.7-88.6 %) with CH-EUS-FNA and 75.3 % (67.0-83.5 %) with EUS-FNA, with evidence of a significant superiority of the former (OR 1.74, 95 % CI 1.26-2.40; p<0.001). Subgroup analysis confirmed the superiority of CH-EUS-FNA over EUS-FNA only in larger lesions (OR 2,38, 1.33-4.25 with the cut-off of 1.5 cm and OR 2.18, 1.12-3.01 with the cut-off of 2 cm). Pooled diagnostic sensitivity of CH-EUS-FNA was 86.2 % (79.7-92.7 %) in hypoenhanced and 89.4 % (82.8-96.0 %) in iso/hyperenhanced lesions (p=0.23). Pooled diagnostic accuracy was 88.8 % (85.6-91.9 %) in CH-EUS-FNA group and 83.6 % (79.4-87.8 %) in EUS-FNA group (OR 1.52, 1.01-2.31; p=0.05). Pooled sample adequacy was 95.1 % (91.1-99.1 %) with CH-EUS-FNA and 89.4 % (81.0-97.8 %) with EUS-FNA (OR 2.40, 1.38-4.17; p = 0.02). No difference in terms of number of needle passes was observed (mean difference: -0.10, -0.28 to 0.08; p = 0.29). Tab. 1 No of studies analyzed No. in CH-EUS-FNA group No. in EUS-FNA group

Key concepts: Medicine, Fine-needle aspiration, Endoscopic ultrasound, Radiology, Contrast (vision), Pancreatic mass, Endoscopy, Ultrasound

Related papers

Related paper 1Related paper 2Related paper 3
Back to paper searchBrowse research topicsOriginal source
Contrast-Enhanced Harmonic Endoscopic Ultrasound (CH-EUS)-Guided Fine-Needle Aspiration Versus Standard Fine-Needle Aspiration In Pancreatic Masses: A Meta-Analysis — Research Paper | ScholarLens