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©The Author(s) 2024.
World J Gastrointest Endosc. Nov 16, 2024; 16(11): 595-606
Published online Nov 16, 2024. doi: 10.4253/wjge.v16.i11.595
Published online Nov 16, 2024. doi: 10.4253/wjge.v16.i11.595
Table 1 Macroscopic on-site evaluation - 2 classification[5]
Score | Aspects of the core | Classification of the biopsy |
0 | No material | Negative |
1 | Haematic or necrotic material | Acceptable |
2 | ≥ 1 core tissue with ≤ 2 mm yellowish-white | Positive |
3 | ≥ 1 core tissue with > 2 mm yellowish-white | Positive |
Table 2 Baseline characteristics of patients who underwent macroscopic on-site evaluation after endoscopic ultrasound-guided fine-needle aspiration or biopsy
Characteristics | |
Age (years), mean ± SD | 59 ± 12 |
Sex, n (%) | |
Female | 499 (49.5) |
Male | 509 (50.5) |
Lesion location, n (%) | |
Pancreas | 664 (62) |
Stomach | 101 (9.4) |
Lymph nodes | 96 (8.9) |
Liver | 46 (4.2) |
Mediastinum | 38 (3.5) |
Other | 129 (12) |
Total | 1074 (100) |
The mean size of the target lesion on EUS (mm), mean ± SD | 38 ± 17 |
Approach, n (%) | |
Transduodenal | 585 (58) |
Transgastric | 350 (34.7) |
Transesophageal | 62 (6.2) |
Transrectal | 11 (1.1) |
Type of the needle (FNA or FNB), n (%) | |
FNA | 101 (10) |
FNA-Expect-Boston | 68 (6.7) |
FNA-EchoTip-Cook | 33 (3.3) |
FNB | 907 (90) |
FNB-Acquire-Boston | 751 (74.5) |
FNB-Medtronic | 20 (2) |
FNB-ProCore-Cook | 40 (4) |
FNB-Trident-Microtech | 96 (9.5) |
Specimen acquisition method, n (%) | |
Suction method | 381 (37.8) |
Capillary method | 290 (28.8) |
Both | 337 (33.4) |
Number of needle passes (FNB), n (%) | |
1 | 154 (15.3) |
2 | 680 (67.5) |
3 | 149 (14.8) |
4 | 25 (2.5) |
Final diagnosis (conclusive or inconclusive), n (%) | |
Conclusive | 963 (95.5) |
Benign | 102 (10.1) |
Malignant | 861 (85.4) |
Inconclusive | 45 (4.5) |
Postprocedural adverse events, n (%) | |
No | 975 (96.7) |
Yes | 33 (3.3) |
Abdominal pain | 17 (1.7) |
Small blood collection | 10 (1) |
Transient fever | 6 (0.6) |
Table 3 Macroscopic on-site evaluation-1 and macroscopic on-site evaluation-2 classifications
Classification | |
MOSE-1 classification, n (%) | |
Score 1: Definite visible tissue core with scanty blood clots | 618 (61.3) |
Score 2: Visible tissue core with moderate blood clots | 325 (32.2) |
Score 3: Scanty tissue core with mainly blood clots | 65 (6.5) |
MOSE-2 classification, n (%) | |
Score 0: Punctio sicca/no material | 0 (0) |
Score 1: Only necrotic or haematic material | 44 (4.4) |
Score 2: ≥ 1 core tissue, ≤ 2 mm yellowish-white | 194 (19.2) |
Score 3: ≥ 1 core tissue, > 2 mm yellowish-white | 770 (76.4) |
Table 4 Relation between macroscopic on-site evaluation classifications and the type of needles and tissue acquisition techniques
MOSE-1 classification | MOSE-2 classification | ||||||
1, n (%)1 | 2, n (%)1 | 3, n (%)1 | P value | Scores 0 and 1, n (%)1 | Scores 2 and 3, n (%)1 | P value | |
Type of the needle | |||||||
FNA-EchoTip | 13 (39.4) | 15 (45.5) | 5 (15.2) | < 0.001 | 1 (3) | 32 (97) | 0.009 |
FNA-Expect | 37 (54.4) | 28 (41.2) | 3 (4.4) | 7 (10.3) | 61 (89.7) | ||
FNB-Acquire | 465 (61.9) | 241 (32.1) | 45 (6) | 33 (4.4) | 718 (95.6) | ||
FNB-Medtronic | 4 (20) | 10 (50) | 6 (30) | 3 (15) | 17 (85) | ||
FNB-Pro Core | 12 (30) | 22 (55) | 6 (15) | 0 (0) | 40 (100) | ||
FNB-Trident-Microtech | 87 (90.6) | 9 (9.4) | 0 (0) | 0 (0) | 96 (100) | ||
Type of the needle (FNA or FNB) | |||||||
FNA | 50 (49.5) | 43 (42.6) | 8 (7.9) | 0.036 | 8 (7.9) | 93 (92.1) | 0.073 |
FNB | 568 (62.6) | 282 (31.1) | 57 (6.3) | 36 (4) | 871 (96) | ||
Size of the needle | |||||||
19 G | 13 (44.8) | 11 (37.9) | 5 (17.2) | 0.034 | 4 (13.8) | 25 (86.2) | 0.249 |
20 G | 11 (28.9) | 20 (52.6) | 7 (18.4) | 1 (2.6) | 37 (97.4) | ||
22 G | 594 (63.1) | 294 (31.2) | 53 (5.6) | 39 (4.1) | 902 (95.9) | ||
Specimen acquisition method | |||||||
Both | 248 (73.6) | 69 (20.5) | 20 (5.9) | < 0.001 | 9 (2.7) | 328 (97.3) | 0.0262 |
Capillary method | 150 (51.7) | 116 (40) | 24 (8.3) | 10 (3.4) | 280 (96.6) | ||
Suction method | 220 (57.7) | 140 (36.7) | 21 (5.5) | 25 (6.6) | 356 (93.4) | ||
Number of needle passes | |||||||
1 | 89 (57.8) | 60 (39) | 5 (3.2) | < 0.001 | 4 (2.6) | 150 (97.4) | < 0.001 |
2 | 451 (66.3) | 197 (29) | 32 (4.7) | 15 (2.2) | 665 (97.8) | ||
3 | 67 (44.9) | 56 (37.6) | 26 (17.5) | 16 (10.7) | 133 (89.3) | ||
4 | 11 (44) | 12 (48) | 2 (8) | 9 (36) | 16 (64) |
Table 5 Relation between the final diagnosis and the type and size of the needle
Final diagnosis | |||
Inconclusive, n (%)1 | Conclusive, n (%)1 | P value | |
Type of needle | |||
FNA-EchoTip-Cook | 4 (12.1) | 29 (87.9) | 0.035a |
FNA-Expect-Boston | 1 (1.5) | 67 (98.5) | |
FNB-Franseen Acquire-Boston | 39 (5.2) | 712 (94.8) | |
FNB-Medtronic | 0 (0) | 20 (100) | |
FNB-ProCore-Cook | 1 (2.5) | 39 (97.5) | |
FNB-Trident-Microtech | 0 (0) | 96 (100) | |
Type of needle (FNA or FNB) | |||
FNA | 5 (5) | 96 (95) | 0.803 |
FNB | 40 (4.4) | 867 (95.6) | |
Size of the needle | |||
19 G | 3 (10.3) | 26 (89.7) | 0.176 |
20 G | 3 (7.9) | 35 (92.1) | |
22 G | 39 (4.1) | 902 (95.9) | |
Specimen acquisition method | |||
Both | 10 (3) | 327 (97) | 0.079 |
Capillary method | 11 (3.8) | 279 (96.2) | |
Suction method | 24 (6.3) | 357 (93.7) | |
MOSE-1 classification | |||
Good cores (score 1) | 16 (2.6) | 602 (97.4) | < 0.001a |
Bloody cores (scores 2 and 3) | 29 (7.4) | 361 (92.6) | |
MOSE-2 classification | |||
Score 2 | 14 (7.2) | 180 (92.8) | 0.002a |
Score 3 | 20 (2.6) | 750 (97.4) |
Table 6 Comparison between scores 2 and 3 in the macroscopic on-site evaluation-2 classification
MOSE-2 classification | P value | ||
Score 2, n (%)1 | Score 3, n (%)1 | ||
Diagnosis conclusive or inconclusive | |||
Inconclusive | 14 (7.2) | 20 (2.6) | 0.002a |
Conclusive | 180 (92.8) | 750 (97.4) | |
Final diagnosis | |||
Inconclusive | 14 (7.2) | 20 (2.6) | < 0.001a |
Benign | 35 (18) | 60 (7.8) | |
Malignant | 145 (74.7) | 690 (89.6) | |
Number of needle passes FNB1 | |||
1 | 32 (16.5) | 118 (15.3) | < 0.001a |
2 | 103 (53.1) | 562 (73) | |
3 | 56 (28.9) | 77 (10) | |
4 | 3 (1.5) | 13 (1.7) |
- Citation: Okasha HH, Hussein HA, Ragab KM, Abdallah O, Rouibaa F, Mohamed B, Ghalim F, Farouk M, Lasheen M, Elbasiony MA, Alzamzamy AE, El Deeb A, Atalla H, El-Ansary M, Mohamed S, Elshair M, Khannoussi W, Abu-Amer MZ, Elmekkaoui A, Naguib MS, Ait Errami A, El-Meligui A, El-Habashi AH, Ameen MG, Abdelfatah D, Kaddah M, Delsa H. Role of macroscopic on-site evaluation of endoscopic ultrasound-guided fine-needle aspiration/biopsy: Results of a multicentric prospective study. World J Gastrointest Endosc 2024; 16(11): 595-606
- URL: https://www.wjgnet.com/1948-5190/full/v16/i11/595.htm
- DOI: https://dx.doi.org/10.4253/wjge.v16.i11.595