An expanded training program for endosonographers improved self-diagnosed accuracy of endoscopic ultrasound-guided fine-needle aspiration cytology of the pancreas

Abstract

Objective. Rapid on-site evaluation (ROSE) of cytologic adequacy improves the diagnostic yield of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA). However, on-site advice from a cytotechnologist or cytopathologist is not always available during EUS-FNA. To enhance endosonographers' ability to assess the adequacy of EUS-FNA specimens, we designed an intensive, 2-h interactive training program. The aim of this study was to determine the usefulness of the program. Methods. Four cytological pictures were selected by a trained cytotechnologist and board-certified cytopathologist from each of the seven patients who underwent EUS-FNA for pancreatic mass in Okayama University Hospital. In total, 28 pictures were used in this study. Twenty endosonographers and 14 cytologists with different levels of EUS-FNA experience evaluated cytological pictures independently before and after the training program. Results. Endosonographers' skill in evaluating the adequacy of EUS-FNA specimens was significantly improved after the completion of the training program (p < 0.001). In contrast, almost all cytologists correctly judged the adequacy of the specimens before taking the training program. Conclusions. This intensive, 2-h interactive training program is useful for endosonographers and capable of improving ROSE of EUS-FNA specimens.

Key Words::

• cytology
• endosonographers
• EUS-FNA
• rapid on-site evaluation

Acknowledgments

We express our deepest appreciation to the attendees of this program: Tsuneyoshi Ogawa, MD, Yutaka Akimoto, MD, Hiroaki Sawahara, MD, Ryota Kawamura, MD, Department of Internal Medicine, Hiroshima City Hospital, Daisuke Goto, MD, Takahito Oka, MD, Noriyo Urata, MD, Department of General Internal Medicine 2, Kawasaki Hospital, Kawasaki Medical School, Masakuni Fujii, MD, Hiroaki Saito, MD, Department of Internal Medicine, Okayama Saiseikai General Hospital, Yoshie Kiyosuke, MD, Tsukasa Yoshida, MD, Department of Gastroenterology, Kurashiki Central Hospital, Takeshi Tomoda, MD, Department of Internal Medicine, Fukuyama City Hospital, Masafumi Inoue, MD, Okayama Red Cross Hospital.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.