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Randomized Controlled Trial
. 2019 Jul;31(4):413-421.
doi: 10.1111/den.13367. Epub 2019 Apr 2.

Mucosal incision-assisted biopsy versus endoscopic ultrasound-guided fine-needle aspiration with a rapid on-site evaluation for gastric subepithelial lesions: A randomized cross-over study

Takashi Osoegawa  1 , Yosuke Minoda  1 , Eikichi Ihara  1 , Keishi Komori  1 , Akira Aso  1 , Ayako Goto  1 , Soichi Itaba  2 , Haruei Ogino  1 , Kazuhiko Nakamura  1 , Naohiko Harada  3 , Kosuke Makihara  4 , Shinichi Tsuruta  5 , Hidetaka Yamamoto  5 , Yoshihiro Ogawa  1
Affiliations
Randomized Controlled Trial

Mucosal incision-assisted biopsy versus endoscopic ultrasound-guided fine-needle aspiration with a rapid on-site evaluation for gastric subepithelial lesions: A randomized cross-over study

Takashi Osoegawa et al. Dig Endosc. 2019 Jul.

Abstract

Objectives: This study aimed to compare the diagnostic yield of mucosal incision-assisted biopsy (MIAB) and endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) with a rapid on-site evaluation (ROSE) for gastric subepithelial lesions (SEL) suspected of being gastrointestinal stromal tumors (GIST) with an intraluminal growth pattern.

Methods: This was a prospective randomized, cross-over multicenter study. The primary outcome was the diagnostic yield of EUS-FNA and MIAB. The secondary outcomes were the technical success rate, complication rate, procedure time and biopsy frequency.

Results: A total of 47 patients were randomized to the MIAB group (n = 23) and EUS-FNA group (n = 24). There was no significant difference in the diagnostic yield of MIAB and EUS-FNA (91.3% vs 70.8%, P = 0.0746). The complication rates of MIAB and EUS-FNA did not differ to a statistically significant extent. The mean procedure time in the MIAB group was significantly longer than that in the EUS-FNA group (34 vs 26 min, P = 0.0011).

Conclusions: The diagnostic yield of MIAB was satisfactorily as high as EUS-FNA with ROSE for gastric SEL with an intraluminal growth pattern.

Keywords: endoscopic ultrasound-guided fine-needle aspiration; gastrointestinal stromal tumor; mucosal incision-assisted biopsy; randomized trial; rapid on-site evaluation.

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