Optimal Number of Needle Punctures in EUS-FNA/B with ROSE for Solid Pancreatic Lesions

<b>Background and Objectives:</b> Endoscopic ultrasonography (EUS)-guided fine-needle aspiration/biopsy (FNA/B) is widely used for solid pancreatic lesions; however, the optimal number of needle punctures required to achieve high diagnostic accuracy remains unclear. This study aimed to i...

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Main Authors: Naomi Uchiyama, Hiroshi Kawakami, Yoshinori Ozono, Hiroshi Hatada, Soichiro Ogawa, Satoshi Sekiguchi, Hiroshi Noguchi, Yuichiro Sato
Format: Article
Language:English
Published: MDPI AG 2025-07-01
Series:Diagnostics
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Online Access:https://www.mdpi.com/2075-4418/15/13/1692
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author Naomi Uchiyama
Hiroshi Kawakami
Yoshinori Ozono
Hiroshi Hatada
Soichiro Ogawa
Satoshi Sekiguchi
Hiroshi Noguchi
Yuichiro Sato
author_facet Naomi Uchiyama
Hiroshi Kawakami
Yoshinori Ozono
Hiroshi Hatada
Soichiro Ogawa
Satoshi Sekiguchi
Hiroshi Noguchi
Yuichiro Sato
author_sort Naomi Uchiyama
collection DOAJ
description <b>Background and Objectives:</b> Endoscopic ultrasonography (EUS)-guided fine-needle aspiration/biopsy (FNA/B) is widely used for solid pancreatic lesions; however, the optimal number of needle punctures required to achieve high diagnostic accuracy remains unclear. This study aimed to identify the ideal number of punctures required for solid pancreatic lesions using EUS-FNA/B. <b>Methods:</b> This single-center retrospective study included 598 patients who underwent EUS-FNA/B for solid pancreatic lesions. We analyzed the cumulative tissue acquisition rates and diagnostic accuracy rates for cytology and histology, and identified the factors associated with diagnostic accuracy using univariate and multivariate analyses. Rapid on-site cytological evaluation was performed in all cases. <b>Results:</b> Cumulative tissue acquisition rates were 95.6% and 92.5% for cytology and histology, respectively. The diagnostic accuracy for cytology increased from 72.6% in the first puncture to 78.8% in the second puncture (<i>p</i> = 0.0233). In contrast, the diagnostic accuracy of histology increased from 72.0% at the first puncture to 83.2% at the third puncture (<i>p</i> = 0.0412). Statistically significant differences were noted between the first and second punctures for cytology, and between the first, second, and third punctures for histology. Univariate and multivariate analyses were conducted to identify factors associated with diagnostic accuracy. In cytology, sex was identified as a significant contributing factor, whereas no independent predictors were found in histology. <b>Conclusions:</b> These findings suggest that two-needle punctures are optimal for cytology, and three-needle punctures are optimal for the histological diagnosis of solid pancreatic lesions using EUS-FNA/B.
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spelling doaj-art-79da8fef2c1b4bccacafe0964e709cf32025-08-20T03:28:33ZengMDPI AGDiagnostics2075-44182025-07-011513169210.3390/diagnostics15131692Optimal Number of Needle Punctures in EUS-FNA/B with ROSE for Solid Pancreatic LesionsNaomi Uchiyama0Hiroshi Kawakami1Yoshinori Ozono2Hiroshi Hatada3Soichiro Ogawa4Satoshi Sekiguchi5Hiroshi Noguchi6Yuichiro Sato7Division of Gastroenterology and Hepatology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki 889-1692, JapanDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki 889-1692, JapanDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki 889-1692, JapanDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki 889-1692, JapanDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki 889-1692, JapanCenter for Animal Disease Control, University of Miyazaki, Miyazaki 889-2192, JapanSection of Oncopathology and Morphological Pathology, Department of Pathology, Faculty of Medicine, University of Miyazaki, Miyazaki 889-1692, JapanSection of Oncopathology and Morphological Pathology, Department of Pathology, Faculty of Medicine, University of Miyazaki, Miyazaki 889-1692, Japan<b>Background and Objectives:</b> Endoscopic ultrasonography (EUS)-guided fine-needle aspiration/biopsy (FNA/B) is widely used for solid pancreatic lesions; however, the optimal number of needle punctures required to achieve high diagnostic accuracy remains unclear. This study aimed to identify the ideal number of punctures required for solid pancreatic lesions using EUS-FNA/B. <b>Methods:</b> This single-center retrospective study included 598 patients who underwent EUS-FNA/B for solid pancreatic lesions. We analyzed the cumulative tissue acquisition rates and diagnostic accuracy rates for cytology and histology, and identified the factors associated with diagnostic accuracy using univariate and multivariate analyses. Rapid on-site cytological evaluation was performed in all cases. <b>Results:</b> Cumulative tissue acquisition rates were 95.6% and 92.5% for cytology and histology, respectively. The diagnostic accuracy for cytology increased from 72.6% in the first puncture to 78.8% in the second puncture (<i>p</i> = 0.0233). In contrast, the diagnostic accuracy of histology increased from 72.0% at the first puncture to 83.2% at the third puncture (<i>p</i> = 0.0412). Statistically significant differences were noted between the first and second punctures for cytology, and between the first, second, and third punctures for histology. Univariate and multivariate analyses were conducted to identify factors associated with diagnostic accuracy. In cytology, sex was identified as a significant contributing factor, whereas no independent predictors were found in histology. <b>Conclusions:</b> These findings suggest that two-needle punctures are optimal for cytology, and three-needle punctures are optimal for the histological diagnosis of solid pancreatic lesions using EUS-FNA/B.https://www.mdpi.com/2075-4418/15/13/1692EUS-FNAEUS-FNBsolid pancreatic lesionsROSEMOSEcumulative tissue acquisition rate
spellingShingle Naomi Uchiyama
Hiroshi Kawakami
Yoshinori Ozono
Hiroshi Hatada
Soichiro Ogawa
Satoshi Sekiguchi
Hiroshi Noguchi
Yuichiro Sato
Optimal Number of Needle Punctures in EUS-FNA/B with ROSE for Solid Pancreatic Lesions
Diagnostics
EUS-FNA
EUS-FNB
solid pancreatic lesions
ROSE
MOSE
cumulative tissue acquisition rate
title Optimal Number of Needle Punctures in EUS-FNA/B with ROSE for Solid Pancreatic Lesions
title_full Optimal Number of Needle Punctures in EUS-FNA/B with ROSE for Solid Pancreatic Lesions
title_fullStr Optimal Number of Needle Punctures in EUS-FNA/B with ROSE for Solid Pancreatic Lesions
title_full_unstemmed Optimal Number of Needle Punctures in EUS-FNA/B with ROSE for Solid Pancreatic Lesions
title_short Optimal Number of Needle Punctures in EUS-FNA/B with ROSE for Solid Pancreatic Lesions
title_sort optimal number of needle punctures in eus fna b with rose for solid pancreatic lesions
topic EUS-FNA
EUS-FNB
solid pancreatic lesions
ROSE
MOSE
cumulative tissue acquisition rate
url https://www.mdpi.com/2075-4418/15/13/1692
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