Antonio Facciorusso, Stefano Francesco Crinò, Alessandro Fugazza, Silvia Carrara, Marco Spadaccini, Matteo Colombo, Daryl Ramai, Benedetto Mangiavillano, Saurabh Chandan, Paraskevas Gkolfakis, Babu Mohan, Cesare Hassan, Alessandro Repici
Endoscopy 2024; 56(01): 31-40
HIGHLIGHTS
- Comparative diagnostic performance of Endoscopic tissue sampling techniques for subepithelial lesions has limited evidence.
- A systematic literature review was conducted for randomized controlled trials (RCTs) comparing the sample adequacy and diagnostic accuracy of bite-on-bite biopsy, mucosal incision-assisted biopsy (MIAB), endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA), and EUS-guided fine-needle biopsy (FNB). Eight RCTs were included.
- EUS-FNB was significantly superior to EUS-FNA in terms of sample adequacy (RR 1.20), whereas none of the other techniques significantly outperformed EUS-FNA.
- EUS-FNB appeared to be the best technique (SUCRA 0.90) followed by MIAB (SUCRA 0.83), whereas bite-on-bite biopsy showed the poorest performance. For lesions <20 mm, MIAB, but not EUS-FNB, showed significantly higher accuracy rates compared with EUS-FNA (RR 1.68; SUCRA 0.86 for adequacy and 0.91 for accuracy).
- When rapid on-site cytological evaluation (ROSE) was available, no difference between EUS-FNB, EUS-FNA, and MIAB was observed.
- The authors concluded that EUS-FNB and MIAB appeared to provide better performance, whereas bite-on-bite sampling was significantly inferior to the other techniques. MIAB seemed to be the best option for smaller lesions, whereas EUS-FNA remained competitive when ROSE was available.