title: Ultrasound-guided percutaneous fine-needle aspiration of solid pancreatic neoplasms: 10-year experience with more than 2,000 cases and a review of the literature.
abstract: OBJECTIVE
  To evaluate the diagnostic accuracy and complication rate of percutaneous ultrasound-guided fine-needle aspiration (US-FNA) of solid pancreatic neoplasms through the analysis of 10-year experiences of two centres.
  
  
  METHODS
  Clinical, radiological and pathologic data of 2,024 patients with solid pancreatic masses who underwent US-FNAs were retrospectively evaluated. Indications for aspiration were: unresectable lesions before neo-adjuvant therapy; doubtful imaging findings; and suspicion of uncommon neoplasms with prognostic or therapeutic implications such as metastases or lymphoma. US-FNAs were performed using aspiration needles with a cytopathologist present in centre 1. In centre 2, cytologic samples were collected with Chiba needles and separately evaluated by a cytopathologist.
  
  
  RESULTS
  US-FNA had a diagnostic sample rate of 92.2 % (centre 1: 95.9 %; centre 2: 87.2 %). US-FNA repetition after non-diagnostic samples provided a diagnosis in 86.3 % of cases. Sensitivity, specificity, positive and negative predictive values, and accuracy were 98.7 %, 100 %, 100 %, 75.5 %, and 98.7 %, respectively. The complication rate was 0.8 %.
  
  
  CONCLUSIONS
  Percutaneous US-FNA is a sensitive, accurate and safe method for the invasive diagnosis of solid pancreatic neoplasms. The use of aspiration needles and the on-site presence of a cytopathologist may lead to a high rate of diagnostic samples, thus reducing the need for US-FNA repetition.
  
  
  CONCLUSIONS
  • Percutaneous ultrasound-guided fine-needle aspiration of pancreatic neoplasms is sensitive and accurate. • The short-term complication rate of percutaneous ultrasound-guided fine-needle aspiration is low. • Technical aspects may influence the rate of diagnostic samples.
authors.affiliation: Department of Radiology, G.B. Rossi Hospital, University of Verona, Piazzale L.A. Scuro 10, 37134, Verona, Italy.
authors.forename: Mirko
authors.initials: M
authors.lastname: D'Onofrio
authors.affiliation: Department of Radiology, Casa di cura Pederzoli, Peschiera del Garda, Italy. riccardo.derobertis@hotmail.it.
authors.forename: Riccardo
authors.initials: R
authors.lastname: De Robertis
authors.affiliation: Department of Radiology, Casa di cura Pederzoli, Peschiera del Garda, Italy.
authors.forename: Emilio
authors.initials: E
authors.lastname: Barbi
authors.affiliation: Department of Radiology, G.B. Rossi Hospital, University of Verona, Piazzale L.A. Scuro 10, 37134, Verona, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Martone
authors.affiliation: Department of Pathology, G.B. Rossi Hospital, University of Verona, Verona, Italy.
authors.forename: Erminia
authors.initials: E
authors.lastname: Manfrin
authors.affiliation: Department of Pathology, Casa di cura Pederzoli, Peschiera del Garda, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Gobbo
authors.affiliation: Department of Radiology, G.B. Rossi Hospital, University of Verona, Piazzale L.A. Scuro 10, 37134, Verona, Italy.
authors.forename: Gino
authors.initials: G
authors.lastname: Puntel
authors.affiliation: Department of Pathology, G.B. Rossi Hospital, University of Verona, Verona, Italy.
authors.forename: Franco
authors.initials: F
authors.lastname: Bonetti
authors.affiliation: Department of Radiology, G.B. Rossi Hospital, University of Verona, Piazzale L.A. Scuro 10, 37134, Verona, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Pozzi Mucelli
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle / Q000009:adverse effects / Q000379:methods; D005188:False Negative Reactions; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D011379:Prognosis; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D018084:Ultrasonography, Interventional / Q000009:adverse effects / Q000379:methods; D055815:Young Adult
keywords: Cytology; Fine-needle aspiration; Neoplasms; Pancreas; Ultrasound