Fine needle biopsy is used to extract tissue samples from the pancreas to analyze for suspected cancer. In 2012, almost 44,000 people will be diagnosed with pancreatic cancer, says the American Cancer Society. The standard procedure for diagnosing pancreatic malignancies is the endoscopic ultrasound guided fine needle aspiration, says Dr. Kenneth Chang, executive director, H.H. Chao Comprehensive Digestive Disease Center at University of California-Irvine.
Fine needle aspiration and endoscopic ultrasound, however, are not 100 percent accurate at detecting pancreatic cancer. The latest development is an improvement in this procedure: a single-use needle that’s disposable, used for both aspiration and biopsy. It’s called the EchoTip ProCore.
In a recent study (Iwashita, et al), this 25-gage needle detected, with 88 percent accuracy, pancreatic tumors after just one pass at the tumor. The accuracy jumped to 91 percent with additional passes. There were no complications in the study patients.
What makes the EchoTip ProCore biopsy needle so unique is that it’s smaller than other fine needle biopsy instruments, enabling it to take samples from hard-to-reach locations, and to be pulled slowly from the tissue. Other unique features of this needle add to its edge in accuracy.
Dr. Chang emphasizes that the EchoTip ProCore gives doctors an advantage because of its accuracy at first-pass detection of pancreatic cancer. This cuts down on the number of patients who must make return visits to their doctors for further sampling. This advanced biopsy needle is available to doctors in most major markets throughout the world.
“If the patient has pancreatic cancer, the only chance for cure or long-term survival is early diagnosis,” says Dr. Chang, in an interview specifically for this article. I wondered what events lead a physician to decide to perform a fine needle biopsy in the first place, since the earlier this procedure detects pancreatic cancer, the better the odds are for the patient’s survival.
Dr. Chang explains that a person may have “unexplained weight loss or pain, or jaundice, or late onset diabetes — and this prompts a CT scan which may show a mass.” The CT scan, however, cannot diagnose; it can only show something suspicious.
After this point, says Dr. Chang, the patient is referred to a gastroenterologist (GI specialist), and this physician then performs the endoscopic ultrasound, using fine needle biopsy – ideally the EchoTip instrument.
Now, another circumstance that can result in the decision to perform fine needle biopsy for a suspected pancreatic tumor is when a patient feels fine, but has an ultrasound or CT scan for an unrelated reason, such as, says Dr. Chang, “screening the liver, looking at the kidneys, or even total body scans for routine check. At this point, a pancreas tumor or cyst may be found and they come to us for endoscopic ultrasound, and EchoTip is chosen.”
The third reason a patient ends up undergoing the fine needle biopsy is that they are at high risk for pancreatic cancer, though not exhibiting symptoms. Perhaps they have a family history of this disease, or other risk factors such as “chronic pancreatitis, genetic susceptibility to pancreas cancer, and presence of certain types of pancreas cysts,” says Dr. Chang. Such patients are referred for endoscopic ultrasound, and the EchoTip needle is used.
Sources:
cancer.org/Cancer/PancreaticCancer/DetailedGuide/pancreatic-cancer-key-statistics.
cancer.org/Cancer/PancreaticCancer/DetailedGuide/pancreatic-cancer-detection.
