Clin Imaging 2015 Jan-Feb;39(1):62-5. Epub 2014 Jun 19.
Division of Abdominal Imaging, Joint Department of Medical Imaging, University Health Network and Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada.
Objective: To assess the efficacy and complication rates of percutaneous ultrasound (US)-guided pancreatic mass biopsy and to determine if location of the mass or method of biopsy affects efficacy.
Methods: Imaging, pathology, and clinical records of all patients undergoing percutaneous US-guided pancreatic mass sampling from January 2001 until November 2011 were reviewed. Of 88 pancreatic masses, 13 underwent fine needle aspiration (FNA) only, 60 underwent core needle biopsy only, and 15 underwent both. Diagnostic rate, sensitivity, specificity, accuracy, and positive predictive value and negative predictive value (NPV) based on location of the mass (head/neck vs. body/tail) and method of biopsy (core vs. FNA vs. combined) were determined. The final diagnosis was determined on the basis of follow-up imaging, clinical course, and/or surgical pathology. Complications were assessed by reviewing clinical notes and postprocedural imaging.
Results: The overall diagnostic rate, sensitivity, accuracy, and NPV of all 88 biopsies were 94%, 93%, 93%, and 57%, respectively. Five samples were nondiagnostic and considered false negatives. There were no false-positive biopsy results. No significant difference was observed in the diagnostic rate, sensitivity, accuracy, and NPV between core biopsies, FNAs, and combined core and FNA biopsies. Furthermore, no significant difference was found between head/neck and body/tail samplings. In 96.7% (85/88) of the cases, the procedure was uneventful. There were no major complications.
Conclusions: Percutaneous US-guided sampling of pancreatic mass is safe and effective irrespective of location of the mass and method of biopsy.