Comparison of EUS-FNB Biopsy Techniques of Solid Pancreatic Lesions

NCT ID: NCT04843956

Last Updated: 2021-04-14

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

41 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-01-08

Study Completion Date

2021-04-30

Brief Summary

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Patients with a diagnosis of solid pancreatic lesions evidenced by imaging studies (CT, MRI) and who undergo endoscopic ultrasound-guided biopsy will be selected. Biopsies will be taken using modified tip needles (FNB) three different methods (capillary by suction, capillary without suction and wet suction).

From the results obtained from the pathology service, 3 variables will be assessed; Cellularity, blood contamination and suitability for a diagnosis.

Detailed Description

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EUS-BAAF procedure The procedure will be performed with a linear echoendoscope (PENTAX 3.8 EG-3870 UTK) and a HITACHI HI VISION Avius ultrasound processor, after deep sedation by the anesthesiology service. BAF Acquire # 22 needles (Boston Scientific, Malborough, MA) will be used. 3 passes will be made to the tumor, each pass will consist of 10-15 movements of the needle back and forth in a fan within the solid lesion, under complete ultrasound control (ESGE 2017- Gastrointest Endoscopy Clin N Am 22 (2012) 155 -167). Doppler will be used to avoid any vascular structure in the path of the needle.

The passes will be in three different ways to compare.

1. Capillary with suction (puncture with gradual withdrawal of the stylet, applying dry suction with a 10 ml air vacuum syringe after removing the stylet)
2. Capillary without suction (puncture with removal of the stylet gradually, without suction after removing the stylet)
3. Moist suction (Before the puncture, the stylet is removed from the needle and irrigated with 1-2 ml saline solution to replace the air column with liquid, then the solid lesion is punctured and suction is placed with a vacuum syringe of 10 ml of air)

The quality of the biopsy will be evaluated by the pathologist independently and without knowing how the sample was obtained.

Conditions

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Pancreatic Neoplasm

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

The samples will be analyzed independently by the pathology service, not knowing the order and the technique in which the samples were obtained. The histopathological result will be immediately available for patient care, however, the score obtained regarding the quality of the sample will correlate with the technique and the number of passes until the n of the study is completed.

Study Groups

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Patients with solid pancreatic lesions

Patients who will undergo endoscopic ultrasound biopsy. Samples of at least 3 passes will be obtained, each pass obtained with a different technique (capillary with suction, capillary without suction and wet suction)

Group Type EXPERIMENTAL

Endoscopic ultrasound-guided biopsy

Intervention Type DIAGNOSTIC_TEST

Capillary with suction (puncture with gradual withdrawal of the stylet, applying dry suction with a 10 ml air vacuum syringe after removing the stylet)

Capillary without suction (puncture with removal of the stylet gradually, without suction after removing the stylet)

wet suction (Prior to puncture, the stylet is removed from the needle and irrigated with 1-2 ml saline solution to replace the air column with liquid, then the solid lesion is punctured and suction is placed with a 10 ml vacuum syringe of air)

Interventions

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Endoscopic ultrasound-guided biopsy

Capillary with suction (puncture with gradual withdrawal of the stylet, applying dry suction with a 10 ml air vacuum syringe after removing the stylet)

Capillary without suction (puncture with removal of the stylet gradually, without suction after removing the stylet)

wet suction (Prior to puncture, the stylet is removed from the needle and irrigated with 1-2 ml saline solution to replace the air column with liquid, then the solid lesion is punctured and suction is placed with a 10 ml vacuum syringe of air)

Intervention Type DIAGNOSTIC_TEST

Other Intervention Names

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Pancreatic biopsy

Eligibility Criteria

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Inclusion Criteria

* Over 18 years old
* Any gender.
* Patients with solid pancreatic lesions evidenced by CT or MRI who do not have a histopathological diagnosis.

Exclusion Criteria

* That no lesion in the pancreas is identified by EUS.
* Pancreatic lesions with a cystic component.
* Alteration of coagulation parameters (INR\> 1.5, Platelets \<50,000 / mm3) or having taken antiplatelet agents or oral anticoagulants one week prior to the biopsy.
* History of acute pancreatitis in the last 4 weeks.
* Pregnant
* Refusal or inability to sign informed consent
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Hospital Universitario Dr. Jose E. Gonzalez

OTHER

Sponsor Role lead

Responsible Party

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Dr. med. Hector Eloy Tamez Perez

Clinical profesor

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Héctor Miguel Delgado Cortes

Monterrey, Nuevo León, Mexico

Site Status RECRUITING

Countries

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Mexico

Central Contacts

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Hector Miguel Delgado Cortes, M.D

Role: CONTACT

+524423395099

Joel Omar Jaquez Quintana

Role: CONTACT

+528114183484

Facility Contacts

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Héctor Miguel Delgado Cortés

Role: primary

4423395099

References

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Lee YN, Moon JH, Kim HK, Choi HJ, Choi MH, Kim DC, Lee TH, Cha SW, Cho YD, Park SH. Core biopsy needle versus standard aspiration needle for endoscopic ultrasound-guided sampling of solid pancreatic masses: a randomized parallel-group study. Endoscopy. 2014 Dec;46(12):1056-62. doi: 10.1055/s-0034-1377558. Epub 2014 Aug 6.

Reference Type BACKGROUND
PMID: 25098611 (View on PubMed)

Crino SF, Manfrin E, Scarpa A, Baldaque-Silva F, Carrara S, De Nucci G, Di Mitri R, Gines A, Iglesias-Garcia J, Itoi T, Kitano M, Nguyen NQ, Deprez PH, Poley JW, Shami VM, Tarantino I, Larghi A. EUS-FNB with or without on-site evaluation for the diagnosis of solid pancreatic lesions (FROSENOR): Protocol for a multicenter randomized non-inferiority trial. Dig Liver Dis. 2019 Jun;51(6):901-906. doi: 10.1016/j.dld.2019.03.008. Epub 2019 Apr 8.

Reference Type BACKGROUND
PMID: 30975612 (View on PubMed)

Bor R, Vasas B, Fabian A, Balint A, Farkas K, Milassin A, Czako L, Rutka M, Molnar T, Szucs M, Tiszlavicz L, Kaizer L, Hamar S, Szepes Z. Prospective comparison of slow-pull and standard suction techniques of endoscopic ultrasound-guided fine needle aspiration in the diagnosis of solid pancreatic cancer. BMC Gastroenterol. 2019 Jan 9;19(1):6. doi: 10.1186/s12876-018-0921-9.

Reference Type BACKGROUND
PMID: 30626331 (View on PubMed)

Aadam AA, Oh YS, Shidham VB, Khan A, Hunt B, Rao N, Zhang Y, Tarima S, Dua KS. Eliminating the Residual Negative Pressure in the Endoscopic Ultrasound Aspirating Needle Enhances Cytology Yield of Pancreas Masses. Dig Dis Sci. 2016 Mar;61(3):890-9. doi: 10.1007/s10620-015-3860-0. Epub 2015 Sep 7.

Reference Type BACKGROUND
PMID: 26346997 (View on PubMed)

Lee JK, Choi JH, Lee KH, Kim KM, Shin JU, Lee JK, Lee KT, Jang KT. A prospective, comparative trial to optimize sampling techniques in EUS-guided FNA of solid pancreatic masses. Gastrointest Endosc. 2013 May;77(5):745-51. doi: 10.1016/j.gie.2012.12.009. Epub 2013 Feb 21.

Reference Type BACKGROUND
PMID: 23433878 (View on PubMed)

Kudo T, Kawakami H, Hayashi T, Yasuda I, Mukai T, Inoue H, Katanuma A, Kawakubo K, Ishiwatari H, Doi S, Yamada R, Maguchi H, Isayama H, Mitsuhashi T, Sakamoto N; Japan EUS-FNA Negative Pressure Suction Study Group. High and low negative pressure suction techniques in EUS-guided fine-needle tissue acquisition by using 25-gauge needles: a multicenter, prospective, randomized, controlled trial. Gastrointest Endosc. 2014 Dec;80(6):1030-7.e1. doi: 10.1016/j.gie.2014.04.012. Epub 2014 Jun 2.

Reference Type BACKGROUND
PMID: 24890422 (View on PubMed)

Bansal RK, Choudhary NS, Puri R, Patle SK, Bhagat S, Nasa M, Bhasin A, Sarin H, Guleria M, Sud R. Comparison of endoscopic ultrasound-guided fine-needle aspiration by capillary action, suction, and no suction methods: a randomized blinded study. Endosc Int Open. 2017 Oct;5(10):E980-E984. doi: 10.1055/s-0043-116383. Epub 2017 Oct 4.

Reference Type BACKGROUND
PMID: 28983505 (View on PubMed)

Li H, Li W, Zhou QY, Fan B. Fine needle biopsy is superior to fine needle aspiration in endoscopic ultrasound guided sampling of pancreatic masses: A meta-analysis of randomized controlled trials. Medicine (Baltimore). 2018 Mar;97(13):e0207. doi: 10.1097/MD.0000000000010207.

Reference Type BACKGROUND
PMID: 29595661 (View on PubMed)

Polkowski M, Jenssen C, Kaye P, Carrara S, Deprez P, Gines A, Fernandez-Esparrach G, Eisendrath P, Aithal GP, Arcidiacono P, Barthet M, Bastos P, Fornelli A, Napoleon B, Iglesias-Garcia J, Seicean A, Larghi A, Hassan C, van Hooft JE, Dumonceau JM. Technical aspects of endoscopic ultrasound (EUS)-guided sampling in gastroenterology: European Society of Gastrointestinal Endoscopy (ESGE) Technical Guideline - March 2017. Endoscopy. 2017 Oct;49(10):989-1006. doi: 10.1055/s-0043-119219. Epub 2017 Sep 12.

Reference Type BACKGROUND
PMID: 28898917 (View on PubMed)

Ge PS, Wani S, Watson RR, Sedarat A, Kim S, Marshall C, Wilson RH, Makker J, Mohamadnejad M, Komanduri S, Muthusamy VR. Per-Pass Performance Characteristics of Endoscopic Ultrasound-Guided Fine-Needle Aspiration of Malignant Solid Pancreatic Masses in a Large Multicenter Cohort. Pancreas. 2018 Mar;47(3):296-301. doi: 10.1097/MPA.0000000000001003.

Reference Type BACKGROUND
PMID: 29401169 (View on PubMed)

Other Identifiers

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GA19-00014

Identifier Type: -

Identifier Source: org_study_id

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