The efficacy of fine needle aspiration biopsies in the diagnosis of pancreas lesions

Abstract

The purpose of our study was to present the technical success and diagnostic accuracy and complications of pancreatic fine needle aspiration biopsies performed under the guidance of imaging methods. A total number of 81 patients (44 male, 37 female) who underwent fine-needle aspiration (FNA) biopsy under the guidance of imaging methods between 2012-2019 were included in the study. The procedure reports and pathology results were examined retrospectively. The biopsies were performed using Chiba type 22-gauge needle with ultrasonography (USG) or computerized tomography (CT). The biopsies reported as inadequate material in the histopathological examination were evaluated as unsuccessful, whereas the biopsies with benign, malignant and suspicious results were evaluated as successful. The median age of the patients included in the study was 68 (range: 40-86 years). Of the 81 pancreatic mass biopsies, 71 were performed with USG (87.7%) and 10 with CT (12.3%). 61 of the lesions were at the pancreas head (75.3%), and 20 at the body-tail (24.7%). 68 of the lesions were solid (83%), 8 were cystic (1%) and 5 were mixed (6%). When the lesion localization and lesion content were evaluated according to biopsy success, no statistical difference was found (p>0.05). While the diagnostic accuracy is 97.3% in lesions over 4 cm, this rate decreases in lesions below 2 cm (60%). A statistically significant difference was found between the lesion size and biopsy success (Pearson chi-square p = 0.011). 7.4% (n = 6) of the pathology results were nondiagnostic. Three of these 6 biopsies were accompanied by CT, while the remaining three were USG-guided. The diagnostic success rate was 95.8% in USG-guided biopsies and 70% in CT-guided biopsies and this difference was statistically significant. (Fisher exact chi-square value p = 0.023). As a conclusion, USG and CT-guided percutaneous FNA is a safe, easy-to-perform, and reproducible procedure with high diagnostic rates in the diagnosis of pancreatic lesions.