Preliminary experience with a new cytology brush in EUS-guided FNA

Gastrointest Endosc. 2009 Dec;70(6):1220-4. doi: 10.1016/j.gie.2009.05.038. Epub 2009 Aug 8.


Background: Despite the high diagnostic yield of EUS-guided FNA, room for technical improvements remains. Recently, the EchoBrush (Cook Endoscopy, Winston-Salem, NC), a disposable cytologic brush, was introduced to the market. To date, only 1 study, limited to 10 pancreatic cyst cases, using this device has been published.

Objective: To assess the diagnostic yield of the EchoBrush in a cohort of consecutive patients, irrespective of the target lesion.

Design: Case series.

Setting: Tertiary care university hospital (Molinette Hospital, Turin, Italy).

Patients: Thirty-nine consecutive patients (12 with solid pancreatic masses, 12 with pancreatic cysts, 7 with enlarged lymph nodes, and 8 with submucosal masses) were enrolled.

Interventions: The material collected with the EchoBrush and with a standard FNA needle was double-blind evaluated by 2 cytopathologists.

Main outcome measurements: Adequacy of the sample and sensitivity and specificity of the EchoBrush method.

Results: Adequate material for cytologic analysis was collected in 17 of 39 patients (43.6%) with a single pass of the EchoBrush. Results were better for pancreatic lesions (for solid and cystic lesions, the adequacy was 58.3% and 50%, respectively); adequacy was low (28.6% and 25%, respectively) for lymph nodes and submucosal masses. The overall sensitivity and specificity were 57.9% and 31.2%, respectively. There were no adverse events with the procedure.

Limitation: Preliminary study.

Conclusions: This report suggests that the EchoBrush may provide adequate cellularity to diagnose solid and cystic pancreatic lesions. More extensive studies are needed to compare the EchoBrush and standard needles.

MeSH terms

  • Biopsy, Fine-Needle / instrumentation*
  • Cytological Techniques / instrumentation*
  • Disposable Equipment
  • Double-Blind Method
  • Endosonography*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pancreatic Cyst / pathology
  • Pancreatic Neoplasms / pathology
  • Sensitivity and Specificity