46 Comparison of Endoscopic Ultrasound Fine-Needle Aspiration and Fine-Needle Biopsy for Solid Pancreatic Masses

INTRODUCTION: The superiority of endoscopic ultrasound (EUS) guided fine needle biopsy (FNB) over fine needle aspiration (FNA) in sampling pancreatic solid masses is still controversial. FNA samples are relatively small and sometimes required increased number of needle passes to obtain a sample with preserved architecture. METHODS: Medical records of 182 patients who underwent ultrasound guided EUS with FNA and/or FNB of pancreatic lesions from University Louisville Hospital were reviewed in this retrospective study. Only those patients who had pancreatic solid mass lesions as pre-procedure diagnosis were included. Size of the lesions were classified in three groups: 0–1 cm, > 1 cm–2 cm, >2 cm. Adequacy of samples were determined by a pathologist. Post-procedure readmissions and/or ER visits, up to one month after EUS, were obtained from University of Louisville medical records. Welch Two sample t-test analysis was performed to assess the relationship between the number of passes and the technique used for biopsy. A P -value < 0.05 deemed statistically significant. RESULTS: 78 patients were included in analysis. The average age was 63 and males represented 59% of the total population. 64% of the lesions were localized on the head, 16% in the tail, 11% in the body, and 9% in the neck of the pancreas. Size of most of the lesions were >2 cm (74%) and >1 cm–2 cm (19%). The mean number passes was 4, SD = 2. Compared with FNA, FNB did not require significantly lower number of passes (3.58 vs 4.36, 95% CI: −0.49, 2.06; P = 0.216). FNA was performed in 41% of the cases. From all the specimens submitted to pathology, there were 0 unsatisfactory specimens in the FNB group, and 2 (7%) unsatisfactory specimens in the FNA group ( P = 0.161). From suspected malignant lesions, FNA could detect 31% of malignant neoplasms, and FNB 41%. Six patients required ER visit/Hospital admission after the procedure, but only 3 patients were admvitted for problems related to the procedure (pancreatitis, intractable nausea and abdominal pain). CONCLUSION: There is no difference between the number of passes between EUS-FNA and EUS-FNB for pancreatic solid masses.