Evaluation of Percutaneous Transabdominal Ultrasound-Guided Core Needle Biopsy and Endoscopic Ultrasound-Guided Fine-Needle Aspiration in Pancreatic Lesions

The objective and purpose of this research are to establish the definition of accuracy of diagnosis for both techniques, EUS-guided fine-needle aspirations (FNA) and ultrasound-guided core biopsies (US-CNB), in the assessment of the pancreatic lesion depending on its size, position, and type of lesions. This study retrospectively reviewed the clinical records of patients who underwent US-CNB or EUS-FNA biopsy for pancreatic lesions between January 2019 and 2022. For each patient, demographic information and information on lesion size, location, and type were obtained. A total of 229 subjects were recruited into the study, with 140 in the US-CNB group and 89 subjects in the EUS-FNA group. The results revealed higher diagnostic efficiency in the US-CNB group compared with the EUS-FNA group, with efficiencies of 96.4% and 70.8%, respectively (P<0.001). Multivariate logistic regression showed that, after adjusting for confounders, US-CNB remained an independent predictor (OR=3.051, P=0.011). After propensity score matching, US-CNB continued to demonstrate significantly higher diagnostic efficiency compared with EUS-FNA (98.4% vs. 71.0%, P<0.001). Diagnostic performance parameters were evaluated in 105 patients with histopathologically established final diagnosis and at least 1 year of follow-up. In addition, US-CNB demonstrated higher sensitivity and specificity when compared with EUS-FNA, which were 92.7% and 83%, respectively. In this retrospective cohort, US-CNB demonstrated higher sample adequacy and sensitivity compared with EUS-FNA for the diagnosis of pancreatic lesions. This advantage was particularly evident in lesions smaller than 4 cm and those located in the head-uncinate process and body of the pancreas.