Accuracy and Quality Assessment of EUS-FNA: A Single-Center Large Cohort of Biopsies
| Autor: | Yoram Kluger, Ron Epelbaum, Ruth Keren, Jesse Lachter, Benjamin Ephraim Bluen, Leonid Malkin, Iyad Khamaysi, Yassin Kamal |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2012 |
| Předmět: |
medicine.medical_specialty
Pathology lcsh:Medical technology Article Subject business.industry Quality assessment Diagnostic accuracy Single Center digestive system diseases Large cohort body regions medicine.anatomical_structure surgical procedures operative Biopsy Site lcsh:R855-855.5 Cytology Medicine Radiology Nuclear Medicine and imaging Radiology Esophagus Medical diagnosis business skin and connective tissue diseases Research Article |
| Zdroj: | Diagnostic and Therapeutic Endoscopy, Vol 2012 (2012) Diagnostic and Therapeutic Endoscopy |
| ISSN: | 1070-3608 |
| DOI: | 10.1155/2012/139563 |
| Popis: | Introduction. Thorough quality control (QC) study with systemic monitoring and evaluation is crucial to optimizing the effectiveness of EUS-FNA. Methods. Retrospective analysis was composed of investigating consecutive patient files that underwent EUS-FNA. QC specifically focused on diagnostic accuracy, impacts on preexisting diagnoses, and case management. Results. 268 patient files were evaluated. EUS-FNA cytology helped establish accurate diagnoses in 92.54% (248/268) of patients. Sensitivity, specificity, PPV, NPV, and accuracy were 83%, 100%, 100%, 91.6%, and 94%, respectively. The most common biopsy site was the pancreas (68%). The most accurate location for EUS-FNA was the esophagus, 13/13 (100%), followed by the pancreas (89.6%). EUS-FNA was least informative for abdominal lymph nodes (70.5%). After FNA and followup, eight false negatives for tumors were found (3%), while 7.5% of samples still lacked a definitive diagnosis. Discussion. QC suggests that the diagnostic accuracy of EUS-FNA might be improved further by (1) taking more FNA passes from suspected lesions, (2) optimizing needle selection (3) having an experienced echo-endoscopist available during the learning curve, and (4) having a cytologist present during the procedure. QC also identified remediable reporting errors. In conclusion, QC study is valuable in identifying weaknesses and thereby augmenting the effectiveness of EUS-FNA. |
| Databáze: | OpenAIRE |
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