Endosonography-guided fine needle aspiration biopsy in the evaluation of pancreatic masses

Am J Gastroenterol. 2002 Jun;97(6):1386-91. doi: 10.1111/j.1572-0241.2002.05777.x.


Objectives: Diagnosis of pancreatic tumors can be problematic. This study aimed to determine the performance of endoscopic ultrasound-guided fine needle aspiration biopsy (EUS FNA) in pancreatic malignancy when prior biopsies performed by CT guidance or ERCP were negative.

Methods: A total of 185 patients with known or suspected pancreatic masses were prospectively evaluated with EUS FNA. Before EUS FNA, all patients were evaluated with abdominal CT (61 with CT-guided biopsy) and 91 with ERCP (41 had brushings or biopsy).

Results: EUS had greater sensitivity than CT in detecting a mass (99% vs 57%, p < 0.0001). In 58 patients with negative CT-guided biopsies, EUS FNA had 90% sensitivity for malignancy, 50% specificity for benign disease and 84% accuracy. Similarly, in 36 patients with negative ERCP tissue sampling, results for EUS FNA were 94%, 67% and 92%, respectively. Complications were mild and infrequent (0.5%).

Conclusion: EUS FNA of pancreatic masses safely and accurately diagnoses pancreatic malignancy when prior biopsy techniques have been unsuccessful.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biopsy, Needle / methods*
  • Cholangiopancreatography, Endoscopic Retrograde
  • Endosonography*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pancreatic Neoplasms / diagnostic imaging*
  • Pancreatic Neoplasms / pathology*
  • Prospective Studies
  • Sensitivity and Specificity
  • Tomography, X-Ray Computed