The Cellularity Yield of Three Different 22-gauge Endoscopic Ultrasound Fine Needle Aspiration Needles
Obtaining a sample from a lesion in the gastrointestinal tract by endoscopic ultrasound (a flexible tube with a camera and small ultrasound machine at its end )requires the use of a needle for taking the sample from the lesion or what we call "Fine needle aspiration (FNA)". Currently, FNA is done by three commercially available needles. These needles are used routinely in our institution for FNA. The data regarding the safety and the successfulness of any of these needles are lacking. We sought to compare all three commercially available needles in a prospective manner.
Pancreatic or Peripancreatic Lesions
Lesions in the Esophagus, Stomach, Duodenum or Rectum
Mediastinal ( Chest) Masses
Enlarged Lymph Nodes
Procedure: Endoscopic Ultrasound Fine Needle Aspiration (EUS-FNA)
|Study Design:||Allocation: Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Parallel Assignment
Masking: Single Blind (Outcomes Assessor)
Primary Purpose: Diagnostic
- 1. Compare the overall diagnostic accuracy of the three commercially available 22 gauge EUS needles [ Time Frame: 2 days after the procedure ] [ Designated as safety issue: No ]Cellularity score will be assessed by the cytopathologist using the scoring system from 0 to 10 score. This scoring system evaluate the amount of blood, malignant cells and contaminant cells. The system is a modified form Mair et al study. " Mair S, Dunbar F, Becker PJ, Du Plessis W. Fine needle cytology--is aspiration suction necessary? A study of 100 masses in various sites. Acta cytologica 1989;33:809-13."
- Compare the complication rate between the three commercially available 22 gauge EUS needles. [ Time Frame: up to 1 month after the procedure ] [ Designated as safety issue: Yes ]The patient will be contacted after the procedure by one week to review any procedure complications. The patient's medical records may be reviewed for up to 6 months after the procedure to review the surgical resection results or the long-term follow-up results. If the patient receives his further care in another hospital, the patient will be contacted by phone for follow-up for a maximum period of 6 months.
- Compare the number of FNA needles passes required to reach the diagnosis. [ Time Frame: During the procedure ( 30 -45 minutes) ] [ Designated as safety issue: No ]The number of passes required to reach the diagnosis
- Compare the technical success of the three commercially available 22 gauge EUS needles [ Time Frame: During the procedure ( 30-45 minutes) ] [ Designated as safety issue: No ]The ability of the needle to perform the intended purpose of the procedure ( reach the lesion and obtain sufficient tissues)
|Study Start Date:||September 2012|
|Estimated Study Completion Date:||March 2014|
|Estimated Primary Completion Date:||January 2014 (Final data collection date for primary outcome measure)|
|Active Comparator: EZ Shot 2 (Olympus America Inc., Center Valley, PA, USA) 22 g||Procedure: Endoscopic Ultrasound Fine Needle Aspiration (EUS-FNA)|
|Active Comparator: Expect™ (Boston Scientific Natick, MA, USA) 22 gauge needle||Procedure: Endoscopic Ultrasound Fine Needle Aspiration (EUS-FNA)|
|Active Comparator: EchoTip® Ultra (Cook Endoscopy, Winston-Salem, NC, USA) 22 g||Procedure: Endoscopic Ultrasound Fine Needle Aspiration (EUS-FNA)|
The following are being done only for research purposes; prior to performing the FNA, The patient will be randomized to one of the three commercially available FNA needles. At this time, all needles are considered equivalent and there is no medical necessity to pick one over another. The sample obtained by the needle will be assigned a quality score based on certain parameters of the sample such as the abundance of diagnostic cells and the presence of blood. We are going to collect certain information about your procedure such as the complications of the procedure, number of needle passes and final diagnosis.
|United States, Texas|
|Texas Tech University Health Sciences Center at El Paso||Recruiting|
|El Paso, Texas, United States, 79905|
|Contact: Mohamed O Othman, MD 914-545-6618|
|Principal Investigator: Mohamed O Othman, MD|