A mucosal incision assisted biopsy vs. endoscopic ultrasound‐guided fine‐needle aspiration with a rapid on‐site evaluation for gastric subepithelial lesions: A randomized crossover study

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 (SELs) suspected of being gastrointestinal stromal tumors (GISTs) with an intraluminal growth pattern.

Methods

This was a prospective randomized crossover, 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 min vs. 26 min; p=0.0011).

Conclusion

The diagnostic yield of MIAB was satisfactorily as high as EUS‐FNA with ROSE for gastric SELs with an intraluminal growth pattern.

Keywords

endoscopic ultrasound‐guided fine‐needle aspiration (EUS‐FNA), gastrointestinal stromal tumor (GIST), mucosal incision assisted biopsy (MIAB), randomized trial, rapid on‐site evaluation (ROSE)

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