title: Conventional versus contrast-enhanced harmonic endoscopic ultrasonography-guided fine-needle aspiration for diagnosis of solid pancreatic lesions: A prospective randomized trial.
abstract: OBJECTIVE
  Contrast-enhanced harmonic endoscopic ultrasonography (CEH-EUS) has been used to diagnose solid pancreatic lesions (SPLs). The aim of this study was to investigate the efficacy of CEH-EUS-guided fine-needle aspiration (CEH-EUS-FNA) compared with that of conventional EUS-FNA for the diagnosis of SPLs.
  
  
  METHODS
  Forty patients with solid pancreatic lesions who visited Fukushima Medical University between September 2013 and June 2014 were recruited for this prospective study. Twenty patients underwent CEH-EUS-FNA, and 20 patients underwent conventional EUS-FNA. The sampling rate, sensitivity, accuracy, and number of needle passes required to obtain sufficient samples were compared between the two groups.
  
  
  RESULTS
  Patient characteristics, sampling rate, accuracy, and sensitivity were not significantly different between the two groups. The final diagnosis of patients who underwent CEH-EUS-FNA was pancreatic cancer in 19 and intraductal papillary mucinous carcinoma in one. Nineteen patients who underwent conventional EUS-FNA were finally diagnosed with pancreatic cancer and one was diagnosed as cancer of the common bile duct. There was a significant difference in the number of needle passes required. A sufficient sample was obtained on one needle pass in 60% (12/20) of CEH-EUS-FNA group compared with 25% (5/20) of the conventional EUS-FNA group.
  
  
  CONCLUSIONS
  Fewer needle passes were required to obtain samples from solid pancreatic lesions using CEH-EUS-FNA than those required using conventional EUS-FNA. Therefore, CEH-EUS-FNA may be more efficient and safer than conventional EUS-FNA for the diagnosis of solid pancreatic lesions.
authors.affiliation: Department of Gastroenterology and Rheumatology, Fukushima Medical University, School of Medicine, Fukushima, Japan.
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Sugimoto
authors.affiliation: Department of Gastroenterology and Rheumatology, Fukushima Medical University, School of Medicine, Fukushima, Japan. Electronic address: daccho@fmu.ac.jp.
authors.forename: Tadayuki
authors.initials: T
authors.lastname: Takagi
authors.affiliation: Department of Endoscopy, Fukushima Medical University Hospital, Fukushima, Japan.
authors.forename: Takuto
authors.initials: T
authors.lastname: Hikichi
authors.affiliation: Department of Gastroenterology and Rheumatology, Fukushima Medical University, School of Medicine, Fukushima, Japan.
authors.forename: Rei
authors.initials: R
authors.lastname: Suzuki
authors.affiliation: Department of Endoscopy, Fukushima Medical University Hospital, Fukushima, Japan.
authors.forename: Ko
authors.initials: K
authors.lastname: Watanabe
authors.affiliation: Department of Gastroenterology and Rheumatology, Fukushima Medical University, School of Medicine, Fukushima, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Nakamura
authors.affiliation: Department of Gastroenterology and Rheumatology, Fukushima Medical University, School of Medicine, Fukushima, Japan.
authors.forename: Hitomi
authors.initials: H
authors.lastname: Kikuchi
authors.affiliation: Department of Gastroenterology and Rheumatology, Fukushima Medical University, School of Medicine, Fukushima, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Konno
authors.affiliation: Department of Gastroenterology and Rheumatology, Fukushima Medical University, School of Medicine, Fukushima, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Waragai
authors.affiliation: Department of Gastroenterology and Rheumatology, Fukushima Medical University, School of Medicine, Fukushima, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Watanabe
authors.affiliation: Department of Endoscopy, Fukushima Medical University Hospital, Fukushima, Japan.
authors.forename: Katsutoshi
authors.initials: K
authors.lastname: Obara
authors.affiliation: Department of Gastroenterology and Rheumatology, Fukushima Medical University, School of Medicine, Fukushima, Japan.
authors.forename: Hiromasa
authors.initials: H
authors.lastname: Ohira
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000000981:diagnostic imaging / Q000473:pathology*; D010190:Pancreatic Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D011446:Prospective Studies; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media
keywords: Contrast-enhanced harmonic endoscopic ultrasonography; Contrast-enhanced harmonic endoscopic ultrasonography-guided fine-needle aspiration; Endoscopic ultrasonography-guided fine-needle aspiration; Pancreatic cancer; Solid pancreatic lesion