title: EUS-guided fine-needle tissue acquisition by using a 19-gauge needle in a selected patient population: a prospective study.
abstract: BACKGROUND
  The ability to obtain tissue samples for histological examination during EUS has theoretical advantages over cytology alone.
  
  
  OBJECTIVE
  To prospectively evaluate the feasibility and yield of EUS-guided fine-needle tissue acquisition (EUS-FNTA) with a large-gauge needle in patients in whom we expected histology to be more useful than cytology to reach a definitive diagnosis.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Tertiary care academic medical center.
  
  
  METHODS
  Consecutive patients with subepithelial lesions, esophagogastric wall thickening, mediastinal and abdominal masses/lymphadenopathy of unknown origin, or pancreatic lesions after nondiagnostic FNA.
  
  
  METHODS
  EUS-FNTA with a 19-gauge needle.
  
  
  METHODS
  Feasibility and yield of EUS-FNTA.
  
  
  RESULTS
  A total of 120 patients with a mean age of 61 ± 14.6 years and mean lesion size of 38 ± 25 mm (range 8-140 mm) were enrolled. FNTA was successfully performed in all but 1 patient (98.9%), and adequate samples for histological examination were obtained in 116 of the 119 patients (97.5%) in whom EUS-FNTA was technically successful. A mean of 2.8 ± 0.8 passes per patient were performed. At the time of current follow-up, a definitive diagnosis was available in 117 of the 120 patients (97.5%), with only 8 false-negative results. The sensitivity, specificity, positive and negative predictive values, and diagnostic accuracy of EUS-FNTA in the 117 patients with a definitive diagnosis were 91.8%, 100%, 100%, 71.4%, and 93.2%, respectively.
  
  
  CONCLUSIONS
  Single-center study with limited power.
  
  
  CONCLUSIONS
  EUS-FNTA by using a large-gauge needle has a high yield and promising diagnostic accuracy and could be used when histology may be more useful than cytology to reach a definitive diagnosis.
authors.affiliation: Digestive Endoscopy Unit, Catholic University, Rome, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Larghi
authors.forename: Elizabeth C
authors.initials: EC
authors.lastname: Verna
authors.forename: Riccardo
authors.initials: R
authors.lastname: Ricci
authors.forename: Tom C
authors.initials: TC
authors.lastname: Seerden
authors.forename: Domenico
authors.initials: D
authors.lastname: Galasso
authors.forename: Antonella
authors.initials: A
authors.lastname: Carnuccio
authors.forename: Naohito
authors.initials: N
authors.lastname: Uchida
authors.forename: Guido
authors.initials: G
authors.lastname: Rindi
authors.forename: Guido
authors.initials: G
authors.lastname: Costamagna
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology*; D000368:Aged; D044963:Biopsy, Fine-Needle / Q000295:instrumentation*; D002294:Carcinoma, Squamous Cell / Q000473:pathology*; D004067:Digestive System Neoplasms / Q000473:pathology*; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008223:Lymphoma / Q000473:pathology*; D008297:Male; D008477:Mediastinal Diseases / Q000473:pathology; D008875:Middle Aged; D009339:Needles; D010195:Pancreatitis / Q000473:pathology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D018084:Ultrasonography, Interventional