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Published on: November 10, 2014
The value of touch imprint cytology in EUS-guided Trucut biopsy
Andrew D Vanderheyden1, Kerry A Proctor, Maged K Rizk
1Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, Iowa 52242, USA.
Background:
EUS-guided Trucut biopsy (TCB) enables the acquisition of tissue cores for histologic assessment. Touch imprint cytology (TIC) can be performed at the time of a biopsy to assess the adequacy of the sample; however, limited information is available on the diagnostic value of TIC of these specimens.
Objective:
To investigate the diagnostic accuracy of TIC compared with a TCB.
Patients And Design:
Consecutive EUS-guided TCB and TIC (n = 109) were retrospectively and independently reviewed by a surgical pathologist (for the TCB) and a cytopathologist (for TIC) blinded to the final diagnoses.
Setting:
University of Iowa Hospitals and Clinics, Iowa.
Main Outcome Measurements:
Diagnostic accuracy of a TCB, TIC, and combined TCB + TIC.
Results:
The diagnostic accuracy of a TCB was 92.7% (95% CI, 83.1%-97.3%), TIC was 82.6% (95% CI, 74.3%-88.6%), and TCB + TIC was 95.4% (95% CI, of 89.4%-98.3%). The diagnostic accuracy of a TCB alone was superior to TIC alone (P = .038); a TCB was diagnostic in 14 cases that were nondiagnostic by TIC. The addition of TIC allowed for the identification of 3 malignancies (2.8%) that were not identified on TCB alone. In 22 cases, TIC was considered diagnostic, but a TCB provided additional specific diagnostic information.
Limitations:
Retrospective study and relatively low numbers.
Conclusions:
TIC is a valuable tool for use in a EUS-guided TCB; TIC is independently diagnostically accurate, which allows for confidence in a rapid preliminary diagnosis, and it provides additional diagnostic value when combined with TCB.
