Needle-based confocal endomicroscopy for pancreatic cysts: the current agreement in interpretation.
Background and Aims Diagnosis of pancreatic cystic lesions (PCLs) remains challenging. EUS with FNA is limited by sampling error and nondiagnostic cytology. Needle-based confocal laser endomicroscopy (nCLE) performed during EUS can be used to improve diagnostic yield via FNA by providing in vivo his...
| Publicado en: | Gastrointestinal Endoscopy Vol. 83; no. 5; pp. 924 - 928 |
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| Autores principales: | , , , , , , , , , , |
| Formato: | abstract research Journal Article |
| Publicado: |
Elsevier B.V.
May2016
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=114627138&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 114627138 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00165107 4A9 jtl: Gastrointestinal Endoscopy issn: 00165107 maglogo: N pubinfo: dt: May2016 vid: 83 iid: 5 pid: 467 pub: Elsevier B.V. place: New York, New York artinfo: ui: 114627138 114627138 114627138 10.1016/j.gie.2015.08.080 114627138 ppf: 924 ppct: 4 formats: tig: atl: Needle-based confocal endomicroscopy for pancreatic cysts: the current agreement in interpretation. aug: au: Karia, Kunal Waxman, Irving Konda, Vani J. Gress, Frank G. Sethi, Amrita Siddiqui, Uzma D. Sharaiha, Reem Z. Kedia, Prashant Jamal-Kabani, Armeen Gaidhane, Monica Kahaleh, Michel affil: Division of Gastroenterology and Hepatology, Weill Cornell Medical College, New York, New York, USA sug: subj: Diagnostic Imaging Optics Pancreatic Cyst Diagnosis Biopsy, Needle Gastroenterology Care Human Pancreatic Cyst Classification Diagnosis, Differential Pancreas Anatomy and Histology Endoscopy Ultrasonography ab: Background and Aims Diagnosis of pancreatic cystic lesions (PCLs) remains challenging. EUS with FNA is limited by sampling error and nondiagnostic cytology. Needle-based confocal laser endomicroscopy (nCLE) performed during EUS can be used to improve diagnostic yield via FNA by providing in vivo histology of PCLs. However, the interobserver agreement (IOA) of nCLE of PCLs has yet to be studied. Methods Fifteen deidentified nCLE video clips of PCLs were sent to 6 interventional endoscopists at 5 institutions. Six variables were assessed for IOA: presence or absence of (1) vessels, (2) villi, (3) dark clumps, (4) reticular pattern, (5) acinar cell s pattern, and (6) debris. PCL interpretation was categorized as mucinous, serous, pseudocyst, malignant, or indeterminate and final diagnosis as benign, malignant, or indeterminate. Results IOA ranged from “poor” to “fair.” The K statistics were –.04 (SE = .05) for vessels, .16 (SE = .07) for villi, .22 (SE = .06) for dark clumps, .13 (SE = .06) for reticular pattern, .14 (SE = .06) for acinar cell s pattern, .06 (SE = .06) for debris, .15 (SE = .03) for interpretation, .13 (SE = .05) for final diagnosis, and .19 (SE = .05) for image quality. The final diagnosis was malignant (10), benign (13), and indeterminate (2). The mean accuracy of the observers was 46%, with the lowest being 20% and highest being 67%. Conclusions The IOA and accuracy for PCL diagnosis were low. The results of this study support the need to identify and validate imaging criteria to determine whether nCLE has diagnostic value for pancreatic pathology. (Clinical trial registration number: NCT02166086.) pubtype: Academic Journal doctype: abstract research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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