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The study is designed to evaluate the diagnostic accuracy of a new designed endoscopic ultrasonography (EUS) Core biopsy aspiration needle in comparison to a conventional EUS aspiration needle in GI-tumors.
Endoscopic ultrasound is an established examination method for tumors of the gastrointestinal tract and the pancreas. Since imaging by itself is limited in differential diagnosis of tumors, EUS guided fine needle aspiration is seen as a valid complementary method. Since fine-needle aspiration (FNA) is mainly based on cytological diagnostics, this method is limited also because of lacking supplementary immune- histochemical diagnostics. Here, the obtainment of little histologically evaluable tissue samples (punched barrels) would be of benefit.
A new punch needle device called Pro-core needle (Cook)(22 / 19 gauges) offers the possibility of increasing numbers of valid extractions of histologically evaluable tissues due to a better targeted precision and maneuverability in comparison to other devices of that kind (tru-cut needles, e.g.). A little notch at the pinpoint allows the obtainment of little tissue samples, that will be kept within the device by aspiration.
This study compares the obtainment of tissue by Proc-core needle and conventional aspiration punction systems.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| EUS guided FNA and fine needle punction | Other | punction of endosonographically identified space-occupying process with aspirating fine needle and pro core fine needle in a randomized order |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| EUS guided FNA and fine needle punction | Device | punction of a suspect area by a EUS guided fine needle as well as pro core fine needle to evacuate histology and smear biologics |
|
| Measure | Description | Time Frame |
|---|---|---|
| Diagnostic Accuracy | Diagnostic accuracy of Pro-core needle (22 G) will be compared to conventional fine needle aspiration (22 G). Therefore EUS-FNA with both needles is undertaken in a random order in each lesion. For Pro-core needle, a histological / cytological diagnosis and quality assessment will be made by pathologists.For Echotip aspiration needle, reference cytology evaluation is done by cytology experts. The histopathological diagnosis after surgery or the clinical follow up of at least one year after EUS FNA is current standard. | up to 1 year |
| Measure | Description | Time Frame |
|---|---|---|
| EUS Pro Core FNA: Histology Samples | Histology (not cytology) samples for Pro-core Needle: Number of adequately evaluable histology samples | day 0 and day 14 |
| Complication Rates | Complication rates of EUS FNA |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Thomas Rösch, Prof. Dr. | University Hospital Eppendorf, Hamburg | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Universitätsklinikum Hamburg-Eppendorf | Hamburg | 20246 | Germany |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 20815858 | Background | Parikh P, Shiloach M, Cohen ME, Bilimoria KY, Ko CY, Hall BL, Pitt HA. Pancreatectomy risk calculator: an ACS-NSQIP resource. HPB (Oxford). 2010 Sep;12(7):488-97. doi: 10.1111/j.1477-2574.2010.00216.x. | |
| 20071702 | Background | van der Gaag NA, Rauws EA, van Eijck CH, Bruno MJ, van der Harst E, Kubben FJ, Gerritsen JJ, Greve JW, Gerhards MF, de Hingh IH, Klinkenbijl JH, Nio CY, de Castro SM, Busch OR, van Gulik TM, Bossuyt PM, Gouma DJ. Preoperative biliary drainage for cancer of the head of the pancreas. N Engl J Med. 2010 Jan 14;362(2):129-37. doi: 10.1056/NEJMoa0903230. |
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| ID | Title | Description |
|---|---|---|
| FG000 | EUS Guided FNA and Fine Needle Punction | punction of endosonographically identified space-occupying process with aspirating fine needle and pro core fine needle in a randomized order EUS guided FNA and fine needle punction: punction of a suspect area by a EUS guided fine needle as well as pro core fine needle to evacuate histology and smear biologics |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| ID | Title | Description |
|---|---|---|
| BG000 | EUS Guided FNA and Fine Needle Punction | punction of endosonographically identified space-occupying process with aspirating fine needle and pro core fine needle in a randomized order EUS guided FNA and fine needle punction: punction of a suspect area by a EUS guided fine needle as well as pro core fine needle to evacuate histology and smear biologics |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | ||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Diagnostic Accuracy | Diagnostic accuracy of Pro-core needle (22 G) will be compared to conventional fine needle aspiration (22 G). Therefore EUS-FNA with both needles is undertaken in a random order in each lesion. For Pro-core needle, a histological / cytological diagnosis and quality assessment will be made by pathologists.For Echotip aspiration needle, reference cytology evaluation is done by cytology experts. The histopathological diagnosis after surgery or the clinical follow up of at least one year after EUS FNA is current standard. | Posted | Number | Diagnostic accuracy (%) | up to 1 year |
|
1 fortnight
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | EUS Guided FNA | EUS FNA of lesions with aspirating fine needle and pro core fine needle in a randomized order |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Professor Dr. Thomas Rösch | Interdisciplinary Endoscopy Department and Clinic University Hospital Hamburg-Eppendorf | +4940 7410 | 50098 | t.roesch@uke.de |
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| ID | Term |
|---|---|
| D010190 | Pancreatic Neoplasms |
| ID | Term |
|---|---|
| D004067 | Digestive System Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D004701 | Endocrine Gland Neoplasms |
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| day 0 and day 14 |
| 19394012 | Background | Moller K, Papanikolaou IS, Toermer T, Delicha EM, Sarbia M, Schenck U, Koch M, Al-Abadi H, Meining A, Schmidt H, Schulz HJ, Wiedenmann B, Rosch T. EUS-guided FNA of solid pancreatic masses: high yield of 2 passes with combined histologic-cytologic analysis. Gastrointest Endosc. 2009 Jul;70(1):60-9. doi: 10.1016/j.gie.2008.10.008. Epub 2009 Apr 25. |
| 15672060 | Background | Takahashi K, Yamao K, Okubo K, Sawaki A, Mizuno N, Ashida R, Koshikawa T, Ueyama Y, Kasugai K, Hase S, Kakumu S. Differential diagnosis of pancreatic cancer and focal pancreatitis by using EUS-guided FNA. Gastrointest Endosc. 2005 Jan;61(1):76-9. doi: 10.1016/s0016-5107(04)02224-2. |
| 17226911 | Background | Iglesias-Garcia J, Dominguez-Munoz E, Lozano-Leon A, Abdulkader I, Larino-Noia J, Antunez J, Forteza J. Impact of endoscopic ultrasound-guided fine needle biopsy for diagnosis of pancreatic masses. World J Gastroenterol. 2007 Jan 14;13(2):289-93. doi: 10.3748/wjg.v13.i2.289. |
| 15483756 | Background | Sudhoff T, Hollerbach S, Wilhelms I, Willert J, Reiser M, Topalidis T, Schmiegel W, Graeven U. [Clinical utility of EUS-FNA in upper gastrointestinal and mediastinal disease]. Dtsch Med Wochenschr. 2004 Oct 15;129(42):2227-32. doi: 10.1055/s-2004-831867. German. |
| 17620230 | Background | Aithal GP, Anagnostopoulos GK, Tam W, Dean J, Zaitoun A, Kocjan G, Ragunath K, Pereira SP. EUS-guided tissue sampling: comparison of "dual sampling" (Trucut biopsy plus FNA) with "sequential sampling" (Trucut biopsy and then FNA as required). Endoscopy. 2007 Aug;39(8):725-30. doi: 10.1055/s-2007-966400. Epub 2007 Jul 10. |
| 16417562 | Background | Wittmann J, Kocjan G, Sgouros SN, Deheragoda M, Pereira SP. Endoscopic ultrasound-guided tissue sampling by combined fine needle aspiration and trucut needle biopsy: a prospective study. Cytopathology. 2006 Feb;17(1):27-33. doi: 10.1111/j.1365-2303.2006.00313.x. |
| 18648133 | Background | Shah SM, Ribeiro A, Levi J, Jorda M, Rocha-Lima C, Sleeman D, Hamilton-Nelson K, Ganjei-Azar P, Barkin J. EUS-guided fine needle aspiration with and without trucut biopsy of pancreatic masses. JOP. 2008 Jul 10;9(4):422-30. |
| 17479313 | Background | Storch I, Shah M, Thurer R, Donna E, Ribeiro A. Endoscopic ultrasound-guided fine-needle aspiration and Trucut biopsy in thoracic lesions: when tissue is the issue. Surg Endosc. 2008 Jan;22(1):86-90. doi: 10.1007/s00464-007-9374-x. Epub 2007 May 4. |
| 16996340 | Background | Storch I, Jorda M, Thurer R, Raez L, Rocha-Lima C, Vernon S, Ribeiro A. Advantage of EUS Trucut biopsy combined with fine-needle aspiration without immediate on-site cytopathologic examination. Gastrointest Endosc. 2006 Oct;64(4):505-11. doi: 10.1016/j.gie.2006.02.056. Epub 2006 Jun 6. |
| 17190771 | Background | Saftoiu A, Vilmann P, Guldhammer Skov B, Georgescu CV. Endoscopic ultrasound (EUS)-guided Trucut biopsy adds significant information to EUS-guided fine-needle aspiration in selected patients: a prospective study. Scand J Gastroenterol. 2007 Jan;42(1):117-25. doi: 10.1080/00365520600789800. |
| 19032453 | Background | Sakamoto H, Kitano M, Komaki T, Noda K, Chikugo T, Dote K, Takeyama Y, Das K, Yamao K, Kudo M. Prospective comparative study of the EUS guided 25-gauge FNA needle with the 19-gauge Trucut needle and 22-gauge FNA needle in patients with solid pancreatic masses. J Gastroenterol Hepatol. 2009 Mar;24(3):384-90. doi: 10.1111/j.1440-1746.2008.05636.x. Epub 2008 Nov 20. |
| 19640524 | Background | Siddiqui UD, Rossi F, Rosenthal LS, Padda MS, Murali-Dharan V, Aslanian HR. EUS-guided FNA of solid pancreatic masses: a prospective, randomized trial comparing 22-gauge and 25-gauge needles. Gastrointest Endosc. 2009 Dec;70(6):1093-7. doi: 10.1016/j.gie.2009.05.037. Epub 2009 Jul 28. |
| 18937186 | Background | Jenssen C, Faiss S, Nurnberg D. [Complications of endoscopic ultrasound and endoscopic ultrasound-guided interventions - results of a survey among German centers]. Z Gastroenterol. 2008 Oct;46(10):1177-84. doi: 10.1055/s-2008-1027334. Epub 2008 Oct 20. German. |
| 16680633 | Background | Bournet B, Migueres I, Delacroix M, Vigouroux D, Bornet JL, Escourrou J, Buscail L. Early morbidity of endoscopic ultrasound: 13 years' experience at a referral center. Endoscopy. 2006 Apr;38(4):349-54. doi: 10.1055/s-2005-921173. |
| 15692930 | Background | Mortensen MB, Fristrup C, Holm FS, Pless T, Durup J, Ainsworth AP, Nielsen HO, Hovendal C. Prospective evaluation of patient tolerability, satisfaction with patient information, and complications in endoscopic ultrasonography. Endoscopy. 2005 Feb;37(2):146-53. doi: 10.1055/s-2005-861142. |
| 18058615 | Background | Al-Haddad M, Wallace MB, Woodward TA, Gross SA, Hodgens CM, Toton RD, Raimondo M. The safety of fine-needle aspiration guided by endoscopic ultrasound: a prospective study. Endoscopy. 2008 Mar;40(3):204-8. doi: 10.1055/s-2007-995336. Epub 2007 Dec 4. |
| 10205212 | Background | Williams DB, Sahai AV, Aabakken L, Penman ID, van Velse A, Webb J, Wilson M, Hoffman BJ, Hawes RH. Endoscopic ultrasound guided fine needle aspiration biopsy: a large single centre experience. Gut. 1999 May;44(5):720-6. doi: 10.1136/gut.44.5.720. |
| 11275888 | Background | O'Toole D, Palazzo L, Arotcarena R, Dancour A, Aubert A, Hammel P, Amaris J, Ruszniewski P. Assessment of complications of EUS-guided fine-needle aspiration. Gastrointest Endosc. 2001 Apr;53(4):470-4. doi: 10.1067/mge.2001.112839. |
| 9097990 | Background | Wiersema MJ, Vilmann P, Giovannini M, Chang KJ, Wiersema LM. Endosonography-guided fine-needle aspiration biopsy: diagnostic accuracy and complication assessment. Gastroenterology. 1997 Apr;112(4):1087-95. doi: 10.1016/s0016-5085(97)70164-1. |
| 16843076 | Background | Buscarini E, De Angelis C, Arcidiacono PG, Rocca R, Lupinacci G, Manta R, Carucci P, Repici A, Carrara S, Vallisa D, Buscarini L, Cosentino F, Pera A, Rizzetto M, Testoni PA, Zambelli A. Multicentre retrospective study on endoscopic ultrasound complications. Dig Liver Dis. 2006 Oct;38(10):762-7. doi: 10.1016/j.dld.2006.06.005. Epub 2006 Jul 13. |
| 27818598 | Result | Sterlacci W, Sioulas AD, Veits L, Gonullu P, Schachschal G, Groth S, Anders M, Kontos CK, Topalidis T, Hinsch A, Vieth M, Rosch T, Denzer UW. 22-gauge core vs 22-gauge aspiration needle for endoscopic ultrasound-guided sampling of abdominal masses. World J Gastroenterol. 2016 Oct 21;22(39):8820-8830. doi: 10.3748/wjg.v22.i39.8820. |
| years |
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| Sex: Female, Male | Count of Participants | Participants |
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| Region of Enrollment | Number | participants |
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| Units | Counts |
|---|
| Participants |
|
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| Secondary | EUS Pro Core FNA: Histology Samples | Histology (not cytology) samples for Pro-core Needle: Number of adequately evaluable histology samples | Histology (not cytology) samples for Pro-core Needle | Posted | Number | participants | day 0 and day 14 |
|
|
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| Secondary | Complication Rates | Complication rates of EUS FNA | Posted | Number | participants | day 0 and day 14 |
|
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| 0 |
| 56 |
| 0 |
| 56 |
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| D004066 |
| Digestive System Diseases |
| D010182 | Pancreatic Diseases |
| D004700 | Endocrine System Diseases |