Meta-Analysis and Systematic Review
Impact of rapid on-site evaluation on the adequacy of endoscopic-ultrasound guided fine-needle aspiration of solid pancreatic lesions: A systematic review and meta-analysis
Anna P Matynia,
Robert L Schmidt,
Gonzalo Barraza,
Lester J Layfield,
Ali A Siddiqui,
Douglas G Adler,
Anna P Matynia
Department of Pathology, University of Utah School of Medicine and ARUP Laboratories, Salt Lake City, Utah, USA
Search for more papers by this authorRobert L Schmidt
Department of Pathology, University of Utah School of Medicine and ARUP Laboratories, Salt Lake City, Utah, USA
Search for more papers by this authorGonzalo Barraza
Department of Pathology, University of Utah School of Medicine and ARUP Laboratories, Salt Lake City, Utah, USA
Search for more papers by this authorLester J Layfield
Department of Pathology, University of Missouri, Columbia, Missouri, USA
Search for more papers by this authorAli A Siddiqui
Department of Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
Search for more papers by this authorCorresponding Author
Douglas G Adler
Gastroenterology Division, University of Utah School of Medicine, Salt Lake City, Utah, USA
Correspondence
Dr Douglas G Adler, University of Utah Gastroenterology Division, 30 North 1900 East 4R118, Salt Lake City, UT 84132-2410, USA. Email: [email protected]
Search for more papers by this authorAnna P Matynia,
Robert L Schmidt,
Gonzalo Barraza,
Lester J Layfield,
Ali A Siddiqui,
Douglas G Adler,
Anna P Matynia
Department of Pathology, University of Utah School of Medicine and ARUP Laboratories, Salt Lake City, Utah, USA
Search for more papers by this authorRobert L Schmidt
Department of Pathology, University of Utah School of Medicine and ARUP Laboratories, Salt Lake City, Utah, USA
Search for more papers by this authorGonzalo Barraza
Department of Pathology, University of Utah School of Medicine and ARUP Laboratories, Salt Lake City, Utah, USA
Search for more papers by this authorLester J Layfield
Department of Pathology, University of Missouri, Columbia, Missouri, USA
Search for more papers by this authorAli A Siddiqui
Department of Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
Search for more papers by this authorCorresponding Author
Douglas G Adler
Gastroenterology Division, University of Utah School of Medicine, Salt Lake City, Utah, USA
Correspondence
Dr Douglas G Adler, University of Utah Gastroenterology Division, 30 North 1900 East 4R118, Salt Lake City, UT 84132-2410, USA. Email: [email protected]
Search for more papers by this authorGrant Support: None
Disclosure: There are no potential conflicts of interest. The authors have nothing to disclose.
Abstract
Background
Rapid on-site evaluation (ROSE) has the potential to improve adequacy rates for endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) of solid pancreatic lesions, but its impact is context-dependent. No studies exist that summarize the relationship between ROSE, number of needle passes, and resulting adequacy rates.
Aims
To analyze data from previous studies to establish if ROSE is associated with improved adequacy rates; to evaluate the relationship between ROSE, number of needle passes, and the resulting adequacy rates of EUS-FNA for solid pancreatic lesions.
Methods
Systematic review and meta-analysis of studies reporting the adequacy rates for EUS-FNA of solid pancreatic lesions.
Results
The search produced 3822 original studies, of which 70 studies met our inclusion criteria. The overall average adequacy rate was 96.2% (95% confidence interval: 95.5, 96.9). ROSE was associated with a statistically significant improvement of up to 3.5% in adequacy rates. There was heterogeneity in adequacy rates across all subgroups. No association between the assessor type and adequacy rates was found. Studies with ROSE have high per-case adequacy and a relatively high number of needle passes in contrast to non-ROSE studies. ROSE is an effect modifier of the relationship between number of needle passes and adequacy.
Conclusions
ROSE is associated with up to 3.5% improvement in adequacy rates for EUS-FNA of solid pancreatic lesions. ROSE assessor type has no impact on adequacy rates. ROSE is an effect modifier on the relationship between needle passes and per-case adequacy for EUS-FNA of solid pancreatic lesions.
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