Combined tissue acquisition, imaging identifies most pancreatic cysts
WASHINGTON — In this exclusive video perspective from Digestive Disease Week 2018, Christopher J. DiMaio, MD, from the Icahn School of Medicine at Mount Sinai in New York, discusses results of a study that examined EUS-guided microforceps biopsy for the diagnosis of pancreatic cystic lesions.
“Our study was aiming to look at the use of some novel tissue acquisition and imaging techniques to see if we can better improve the diagnosis of pancreatic cysts,” DiMaio told Healio Gastroenterology and Liver Disease. “This was a retrospective study of our first 32 patients, where we used a combination of needle-based confocal laser endomicroscopy plus the use of microbiopsy forceps to biopsy the cyst wall in combination with standard pancreatic cyst fluid analysis and cytology.”
DiMaio and colleagues analyzed 32 patients with a cyst in the head, neck, body, tail or uncinate. Compared with cytology alone, the diagnostic yield was significantly higher with microbiopsy forceps (61% vs. 17%; P < .05) or needle-based confocal laser endomicroscopy (96% vs. 17%; P < .05). Needle-based confocal laser endomicroscopy was also significantly higher than microbiopsy forceps alone (P < .05) or the combination of forceps and cytology (96% vs. 70%; P < .05).
The combination of needle-based confocal laser endomicroscopy and microbiopsy forceps yielded 100% diagnostic value (P < .05).
“We think this is very important, because we can more reliably and accurately describe, assist and guide patient management better, whether that be the suspension of further imaging or surveillance because of it being a benign serous cyst adenoma or proceeding to surgical resection if it’s a precancerous lesion,” DiMaio said. “Having this information, we think, is quite powerful and has the potential to impact patient care.”
DiMaio CJ, et al. Abstract Mo1297. Presented at: Digestive Disease Week; June 2-5, 2018; Washington, D.C.
Disclosures: DiMaio reports speaking and teaching or other financial benefits from Boston Scientific and Medtronic. Please see the DDW faculty disclosure index for a list of all other authors’ relevant financial disclosures.