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News

Endoscopic ultrasound-guided fine needle aspiration of solid pancreatic lesions

This month's issue of Endoscopy evaluates the diagnostic accuracy of 22-gauge and 25-gauge needles in endoscopic ultrasound-guided fine needle aspiration of solid pancreatic lesions.

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It is uncertain if needle gauge impacts the diagnostic accuracy of endoscopic ultrasound-guided fine needle aspiration of pancreatic mass lesions.

Dr Madhoun from Oklahoma, USA and colleagues performed a meta-analysis to more robustly define the diagnostic accuracy of endoscopic ultrasound-guided fine needle aspiration for pancreatic masses using 22 G and 25 G needles.

The research team identified studies by searching 9 medical databases for reports published between 1994 and 2011, using a reproducible search strategy comprised of relevant terms.

Only studies comparing the overall diagnostic accuracy of 22 G vs 25 G endoscopic ultrasound-guided needles that used surgical histology or at least 6 months clinical follow up for a gold standard were included.

The doctors assessed that 2 reviewers independently scored the identified studies for methodology and abstracted pertinent data.

The pooled sensitivity of the 22 G needle was 0.8
Endoscopy

When required, the original investigators were contacted to provide additional data.

Pooling was conducted by both fixed-effects and random-effects models.

The researchers evaluated 8 studies involving 1292 subjects that met the defined inclusion criteria.

The team of doctors noted that tf the 1292 patients, 799 were in the 22 G group, and 565 were in the 25 G group.

The pooled sensitivity and specificity of the 22 G needle were 0.8 and 1 respectively.

The researchers reported that the pooled sensitivity and specificity of the 25 G needle were 0.93 and 0.97 respectively.

The bivariate generalized linear random-effect model indicated that the 25 G needle is associated with a higher sensitivity but comparable specificity to the 22 G needle.

Dr Madhoun's team concluded, "This meta-analysis suggests 25 G needle systems are more sensitive than 22 G needles for diagnosing pancreatic malignancy."

Endoscopy 2013; 45(2): 86-92
22 February 2013

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