Clin Endosc.  2019 Jul;52(4):334-339. 10.5946/ce.2019.004.

A “Back Light System” for Identification of Sites for Endoscopic Ultrasound-Guided Fine-Needle Aspiration in Solid Pancreatic Masses: A Prospective, Randomized Study with a Crossover Design

• Harada R
• Kato H
• Fushimi S
• Inoue H
• Uchida D
• Akimoto Y
• Tomoda T
• Matsumoto
• Noma Y
• Yamamoto N
• Horiguchi
• Tsutsumi K
• Okada H

• KMID: 2455629
• DOI: http://doi.org/10.5946/ce.2019.004

Abstract

BACKGROUND/AIMS
We applied a back light system (BLS) with a magnifying glass to improve the ability to assess the adequacy of specimen sampling using endosonography. We conducted this study to evaluate the efficacy of the BLS in sampling of specimens by endoscopic ultrasound-guided fine needle aspiration of solid pancreatic masses.
METHODS
This was a prospective, randomized, crossover, single-center clinical trial. An endosonographer evaluated adequacy on gross visual inspection and identified whitish specimen sampling sites with and without the BLS according to a randomization sequence in the first and second passes with a 25-G needle. On cytological evaluation, the presence of well-defined pancreatic ductal epithelium was evaluated by a cytopathologist who was blinded to any clinical information.
RESULTS
A total of 80 consecutive patients were eligible during the study period. Adequacy was observed for 52 specimens (65%) with the BLS and 54 (68%) without the BLS (p=0.88). In assessment of specimen adequacy on gross examination, only fair agreement was observed both with and without BLS (kappa score 0.40 and 0.29, respectively).
CONCLUSIONS
The BLS did not influence the ability to identify specimen sampling sites or reliable assessment of specimen site adequacy using gross visual inspection.

Keyword

Endosonographer; Cytology; Rapid on-site evaluation; Endoscopic ultrasound-guided fine-needle aspiration; Pancreatic neoplasms

MeSH Terms

Biopsy, Fine-Needle*
Cross-Over Studies*
Endoscopic Ultrasound-Guided Fine Needle Aspiration
Endosonography
Epithelium
Glass
Humans
Needles
Pancreatic Ducts
Pancreatic Neoplasms
Prospective Studies*
Random Allocation

Figure

• 

  Fig. 1. (A) Back light system with a magnifying glass. (B) The back light system clearly showed white areas in an endoscopic ultrasound-guided fine needle aspiration specimen (arrows).

• 

  Fig. 2. Trial profile.

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