title: The presence of rapid on-site evaluation did not increase the adequacy and diagnostic accuracy of endoscopic ultrasound-guided tissue acquisition of solid pancreatic lesions with core needle.
abstract: Rapid on-site evaluation (ROSE) improves the adequacy and accuracy of EUS-guided tissue acquisition, although it is not routinely widely available. Evidence suggested that core needles might overcome the absence of ROSE. The aim of this study was to evaluate the influence of ROSE on the adequacy and accuracy of EUS-guided tissue acquisition with core needles in patients with pancreatic solid lesions.
  
  
  
  Patients who underwent EUS-guided tissue acquisition of pancreatic mass lesions were retrospectively identified at three tertiary referral centers and those performed with the core needle were included. Adequacy, defined as the rate of cases in which a tissue specimen for proper examination was achieved, with and without ROSE was the primary outcome measure. The diagnostic accuracy and tissue core acquisition were the secondary outcome measures.
  
  
  
  A total of 333 patients with pancreatic solid mass lesions were included in the study; 140 cases sampled with ROSE and 193 cases without ROSE. The adequacy was 92.1 % in the group sampled with ROSE and 88.1 % in the group without ROSE (p = 0.227). In the ROSE group sensitivity, specificity, and accuracy were 90.7, 100 and 92.1 %, respectively. In the group without ROSE, sensitivity, specificity, and accuracy were 87.2, 100, and 88.1 %, respectively. No difference for all these figures was observed between the two groups. The tissue core was available in 61.4 and 53.4 % of cases with and without ROSE, respectively (p = 0.143).
  
  
  
  In the absence of ROSE, EUS-based tissue acquisition with Core needle should be considered since it achieves comparable tissue sampling adequacy and accuracy.
authors.affiliation: Unit of Gastroenterology and Digestive Endoscopy, AUSL Bologna, Bellaria-Maggiore Hospital, 40133, Bologna, Italy. carlo.fabbri@ausl.bologna.it.
authors.forename: Carlo
authors.initials: C
authors.lastname: Fabbri
authors.affiliation: Division of Gastroenterology, Department of Medical and Surgical Sciences, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Fuccio
authors.affiliation: Pathology Service, AUSL Bologna, Bellaria-Maggiore Hospital, Bologna, Italy.
authors.forename: Adele
authors.initials: A
authors.lastname: Fornelli
authors.affiliation: Department of Gastroenterology, A. Murri Hospital, Fermo, Italy.
authors.forename: Filippo
authors.initials: F
authors.lastname: Antonini
authors.affiliation: Pathology Service, Department of Diagnostic and Therapeutic Services, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (ISMETT), Palermo, Italy.
authors.forename: Rosa
authors.initials: R
authors.lastname: Liotta
authors.affiliation: Division of Gastroenterology, Department of Medical and Surgical Sciences, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
authors.forename: Leonardo
authors.initials: L
authors.lastname: Frazzoni
authors.affiliation: Digestive Endoscopy Unit, Catholic University, Rome, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Larghi
authors.affiliation: Unit of Gastroenterology and Digestive Endoscopy, AUSL Bologna, Bellaria-Maggiore Hospital, 40133, Bologna, Italy.
authors.forename: Antonella
authors.initials: A
authors.lastname: Maimone
authors.affiliation: Gastroenterology Unit, Valduce Hospital, Como, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Paggi
authors.affiliation: Pathology Service, A. Murri Hospital, Polytechnic University of Marche, Fermo, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Gusella
authors.affiliation: Endoscopy Service, Department of Diagnostic and Therapeutic Services, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (ISMETT), Palermo, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Barresi
authors.affiliation: Unit of Gastroenterology and Digestive Endoscopy, AUSL Bologna, Bellaria-Maggiore Hospital, 40133, Bologna, Italy.
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Polifemo
authors.affiliation: Emergency and General Surgery Department, AUSL Bologna, Bellaria-Maggiore Hospital, Bologna, Italy.
authors.forename: Elio
authors.initials: E
authors.lastname: Iovine
authors.affiliation: Department of Gastroenterology, A. Murri Hospital, Fermo, Italy.
authors.forename: Giampiero
authors.initials: G
authors.lastname: Macarri
authors.affiliation: Unit of Gastroenterology and Digestive Endoscopy, AUSL Bologna, Bellaria-Maggiore Hospital, 40133, Bologna, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Cennamo
authors.affiliation: Endoscopy Service, Department of Diagnostic and Therapeutic Services, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (ISMETT), Palermo, Italy.
authors.forename: Ilaria
authors.initials: I
authors.lastname: Tarantino
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology; D000368:Aged; D018278:Carcinoma, Neuroendocrine / Q000473:pathology; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration; D005260:Female; D006801:Humans; D008297:Male; D010179:Pancreas / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000473:pathology*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
keywords: EUS; Endoscopic ultrasound; Fine-needle aspiration; Pancreatic cancer; ROSE; Rapid on-site evaluation