Year 2017 / Volume 109 / Number 4
Review
Onsite evaluation of endoscopic ultrasound fine needle aspiration: the endosonographer, the cytotechnologist and the cytopathologist

279-283

DOI: 10.17235/reed.2017.4473/2016

Jonathan Wyse, Maria Rubino, Julio Iglesias Garcia, Anand V. Sahai,

Abstract
Endoscopic ultrasound guided fine needle aspiration (EUS-FNA) has become an essential tool in the management of multiple diseases. Its accuracy is related to different aspects of the technique, one of the most important being the experience and interaction of the endosonographer and pathologist. Certain studies over the past years have highlighted the importance of having rapid on-site evaluation (ROSE) of samples obtained at the time of EUS-FNA. We have reviewed the role of ROSE, performed by the same endosonographer, a cytotechnologist and an expert cytopathologist. The available data suggest that ROSE (either by the endosonographer, the cytotechnologist, or the cytopathologist) improves sample adequacy and diagnostic yield, with the best option to have ROSE performed by an expert cytopathologist. However, if non-ROSE accuracy is already very high, any improvement is harder to achieve.
Share Button
New comment
Comments
No comments for this article
References
1. Logroño R, Waxman I. Interactive role of the cytopathologist in EUS-guided fine needle aspiration: an efficient approach. Gastrointest Endosc 2001; 54(4): 485-90.
2. Schmidt RL, Kordy MA, Howard K, et al. The influence of rapid onsite evaluation on the adequacy rate of fine-needle aspiration cytology: a systematic review and meta-analysis. Am J Clin Pathol 2013; 139(3): 300-8.
3. Wyse JM, Chen YI, Sahai AV. Randomized, double-blind, controlled trial of early endoscopic ultrasound-guided celiac plexus neurolysis to prevent pain progression in patients with newly diagnosed, painful, inoperable pancreatic cancer. J Clin Oncol 2011; 29(26): 3541-6.
4. Savoy AD, Raymond M, Woodward TA, et al. Can endosonographers evaluate on-site cytologic adequacy? A comparison with cytotechnologists. Gastrointest Endosc 2007; 65(7): 953-7.
5. Hikichi T, Irisawa A, Bethany MS, et al. Endoscopic ultrasound-guided fine-needle aspiration of solid pancreatic masses with rapid on-site cytological evaluation by endosonographers without attendance of cytopathologists. J Gastroenterol 2009; 44(4): 322-8.
6. Harada R, Kato H, Fushimi S, et al. An expanded training program for endosonographers improved self-diagnosed accuracy of endoscopic ultrasound-guided fine-needle aspiration cytology of the pancreas. Scand J Gastroenterol 2014; 49(9): 1119-23.
7. Hayashi T, Ishiwatari H, Yoshida M, et al. Rapid on-site evaluation by endosonographer during endoscopic ultrasound-guided fine needle aspiration for pancreatic solid masses. J Gastroenterol Hepatol 2013; 28(4): 656-63.
8. Nguyen YP, Maple JT, Zhang Q, et al. Reliability of gross visual assessment of specimen adequacy during EUS-guided FNA of pancreatic masses. Gastrointest Endosc 2009; 69(7): 1264-70.
9. Alsohaibani F, Girgis S, Sandha GS. Does onsite cytotechnology evaluation improve the accuracy of endoscopic ultrasound-guided fine-needle aspiration biopsy? Can J Gastroenterol 2009; 23(1): 26-30.
10. Nayar MK, Chatterjee S, Wader V, et al. Does on-site adequacy assessment by cytotechnologists improve results of EUS guided FNA of solid pancreaticobiliary lesions? JOP 2013; 14(1): 44-9.
11. Iqbal S, Frieden D, Gupta M, et al. Endoscopic-ultrasound-guided fine-needle aspiration and the role of the cytopathologist in solid pancreatic lesion diagnosis. Patholog Res Int 2012; 2012: 3171-67.
12. Klapman JB, Logroño R, Dye CE, et al. Clinical impact of on-site cytopathology interpretation on endoscopic ultrasound-guided fine needle aspiration. Am J Gastroenterol 2003; 98(6): 1289-94.
13. Ecka RS, Sharma M. Rapid on-site evaluation of EUS-FNA by cytopathologist: an experience of a tertiary hospital. Diagn Cytopatho 2013; 41(12):1075-80.
14. Iglesias-Garcia J, Dominguez-Muñoz JE, Abdulkader I, et al. Influence of on-site cytopathology evaluation on the diagnostic accuracy of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) of solid pancreatic masses. Am J Gastroenterol 2011; 106(9): 1705-10.
15. Schmidt RL. Studies on the impact of onsite evaluation must account for the per-pass success rate. Dig Endosc 2013; 25(5): 550.
16. Suzuki R, Irisawa A, Bhutan MS, et al. Prospective evaluation of the optimal number of 25-gauge needle passes for endoscopic ultrasound-guided fine-needle aspiration biopsy of solid pancreatic lesions in the absence of an onsite cytopathologist. Dig Endosc 2012; 24(6): 452-6.
17. Cherian PT, Mohan P, Douiri A, et al. Role of endoscopic ultrasound-guided fine-needle aspiration in the diagnosis of solid pancreatic and peripancreatic lesions: is onsite cytopathology necessary? HPB (Oxford) 2010; 12(6): 389-95.
18. Nasuti JF, Gupta PK, Baloch ZW. Diagnostic value and cost-effectiveness of on-site evaluation of fine-needle aspiration specimens: review of 5,688 cases. Diagn Cytopathol 2002; 27(1): 1-4.
19. Hebert-Magee S, Bae S, Varadarajulu S, et al. The presence of a cytopathologist increases the diagnostic accuracy of endoscopic ultrasound-guided fine needle aspiration cytology for pancreatic adenocarcinoma: a meta-analysis. Cytopathology, 2013; 24(3): 159-71.
20. Eloubeidi MA, Tamhane A, Jhala N, et al. Agreement between rapid onsite and final cytologic interpretations of EUS-guided FNA specimens: implications for the endosonographer and patient management. Am J Gastroenterol, 2006; 101(12): 2841-7.
21. Jhala NC, Eltoum IA, Eloubeidi MA, et al., Providing on-site diagnosis of malignancy on endoscopic-ultrasound-guided fine-needle aspirates: should it be done? Ann Diagn Pathol, 2007; 11(3): 176-81.
22. Wyse JM, Chen YI, Sahai AV. Sahai, Celiac plexus neurolysis in the management of unresectable pancreatic cancer: when and how? World J Gastroenterol 2014; 20(9): 2186-92.
23. Yvon WJ, Brugge WR. Endoscopic ultrasonography-guided tumor ablation. Gastrointest Endosc Clin N Am 2012; 22(2): 359-69.
24. Zhang B, Li L, Zhang J, et al. Improving ethanol and xylitol fermentation at elevated temperature through substitution of xylose reductase in Kluyveromyces marxianus. J Ind Microbiol Biotechnol 2013; 40(3-4): 305-16.
25. Choi JH, Seo DW, Park do H, et al. Fiducial placement for stereotactic body radiation therapy under only endoscopic ultrasonography guidance in pancreatic and hepatic malignancy: practical feasibility and safety. Gut Liver 2014; 8(1): 88-93.
26. Arcidiacono PG, Carrara S, Reni M, et al. Feasibility and safety of EUS-guided cryothermal ablation in patients with locally advanced pancreatic cancer. Gastrointest Endosc 2012; 76(6): 1142-51.
27. Wang KX, Jin ZD, Du YQ, et al., EUS-guided celiac ganglion irradiation with iodine-125 seeds for pain control in pancreatic carcinoma: a prospective pilot study. Gastrointest Endosc 2012; 76(5): 945-52.
Citation tools
Wyse J, Rubino M, Iglesias Garcia J, Sahai A. Onsite evaluation of endoscopic ultrasound fine needle aspiration: the endosonographer, the cytotechnologist and the cytopathologist. 4473/2016


Download to a citation manager

Download the citation for this article by clicking on one of the following citation managers:

Metrics
This article has received 835 visits.
This article has been downloaded 256 times.

Statistics from Dimensions


Statistics from Plum Analytics

Publication history

Received: 27/05/2016

Accepted: 19/09/2016

Online First: 23/01/2017

Published: 31/03/2017

Article revision time: 109 days

Article Online First time: 241 days

Article editing time: 308 days


Share
This article hasn't been rated yet.
Reader rating:
Valora este artículo:




Asociación Española de Ecografía Digestiva Sociedad Española de Endoscopia Digestiva Sociedad Española de Patología Digestiva
The Spanish Journal of Gastroenterology is the official organ of the Sociedad Española de Patología Digestiva, the Sociedad Española de Endoscopia Digestiva and the Asociación Española de Ecografía Digestiva
Cookie policy Privacy Policy Legal Notice © Copyright 2023 y Creative Commons. The Spanish Journal of Gastroenterology