Prospective Trial of EUS-FNA Versus EUS-FNB Using a Novel Core Biopsy Needle

NCT ID: NCT01769248

Last Updated: 2018-01-18

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

140 participants

Study Classification

INTERVENTIONAL

Study Start Date

2012-09-30

Study Completion Date

2014-02-28

Brief Summary

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Endoscopic ultrasound (EUS) is paramount in the diagnosis and evaluation of cancers involving the gastrointestinal tract. EUS allows for the acquisition of cellular (fine needle aspirate - FNA) or tissue biopsy (fine needle biopsy - FNB) for diagnostic purposes. This has traditionally been done with fine needle aspirate where a needle is inserted into the tumor and potentially malignant cells are extracted for microscopic analysis. More recently, a needle that allows a tissue biopsy for histologic analysis has been FDA approved.

The Echotip Procore (Cook Medical) core biopsy needle (ETP), has been demonstrated to provide excellent efficacy for core biopsy samples. Final diagnostic yield using this needle ranges from 80-90% and appears to be significantly greater than EUS-FNA for lesions requiring histology for diagnosis. However, there is currently only limited data from prospective studies comparing EUS-FNA to EUS-FNB with the ETP needle. The investigators propose a randomized, prospective, cross-over study comparing diagnostic accuracy of EUS-FNA to EUS-FNB.

Detailed Description

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Endoscopic ultrasound (EUS) is paramount in the diagnosis and evaluation of cancers involving the gastrointestinal tract. EUS allows for the acquisition of cellular (fine needle aspirate - FNA) or tissue biopsy (fine needle biopsy - FNB) for diagnostic purposes. This has traditionally been done with fine needle aspirate where a needle is inserted into the tumor and potentially malignant cells are extracted for microscopic analysis. More recently, a needle that allows a tissue biopsy for histologic analysis has been FDA approved.

We will compare tissue samples obtained by standard FNA to FNB with a sample size of 140 patients with the primary outcome being diagnostic yield. Each patient will be randomized to FNA or FNA. If after 3 passes the on-site evaluation remains inadequate, the endoscopist will crossover to the other arm.

Conditions

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Pancreatic Cancer Lymphadenopathy Gastrointestinal Stromal Tumor

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

Study Groups

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Fine needle aspiration

fine needle aspiration

Group Type ACTIVE_COMPARATOR

Fine needle aspiration

Intervention Type DEVICE

Fine needle aspiration

Fine needle biopsy

Intervention Type DEVICE

FNB

Fine needle biopsy

Fine needle biopsy

Group Type ACTIVE_COMPARATOR

Fine needle aspiration

Intervention Type DEVICE

Fine needle aspiration

Fine needle biopsy

Intervention Type DEVICE

FNB

Interventions

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Fine needle aspiration

Fine needle aspiration

Intervention Type DEVICE

Fine needle biopsy

FNB

Intervention Type DEVICE

Other Intervention Names

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Echo Tip FNA Needle Echo Tip Procore

Eligibility Criteria

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Inclusion Criteria

\- 3.1.1 All patients referred for EUS tissue sampling who provide informed consent

Exclusion Criteria

* 3.2.1 Coagulopathy which is not corrected

3.2.2 Diagnostic EUS determines lesion is not amenable to FNA or FNB
Minimum Eligible Age

18 Years

Maximum Eligible Age

90 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Northwestern University

OTHER

Sponsor Role lead

Responsible Party

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Sri Komanduri

Associate Professor of Medicine

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Srinadh Komanduri

Role: PRINCIPAL_INVESTIGATOR

Northwestern University

Locations

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UCLA Medical Center

Los Angeles, California, United States

Site Status

California Pacific Medical Center

San Francisco, California, United States

Site Status

Moffit Cancer Center

Tampa, Florida, United States

Site Status

Countries

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United States

Other Identifiers

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FNAFNBmucin

Identifier Type: -

Identifier Source: org_study_id

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