Preliminary experience with a new cytology brush in EUS-guided FNA.

Background: Despite the high diagnostic yield of EUS-guided FNA, room for technical improvements remains. Recently, the EchoBrush (Cook Endoscopy, Winston-Salem, NC), a disposable cytologic brush, was introduced to the market. To date, only 1 study, limited to 10 pancreatic cyst cases, using this device has been published.
Objective: To assess the diagnostic yield of the EchoBrush in a cohort of consecutive patients, irrespective of the target lesion.
Design: Case series.
Setting: Tertiary care university hospital (Molinette Hospital, Turin, Italy).
Patients: Thirty-nine consecutive patients (12 with solid pancreatic masses, 12 with pancreatic cysts, 7 with enlarged lymph nodes, and 8 with submucosal masses) were enrolled.
Interventions: The material collected with the EchoBrush and with a standard FNA needle was double-blind evaluated by 2 cytopathologists.
Main Outcome Measurements: Adequacy of the sample and sensitivity and specificity of the EchoBrush method.
Results: Adequate material for cytologic analysis was collected in 17 of 39 patients (43.6%) with a single pass of the EchoBrush. Results were better for pancreatic lesions (for solid and cystic lesions, the adequacy was 58.3% and 50%, respectively); adequacy was low (28.6% and 25%, respectively) for lymph nodes and submucosal masses. The overall sensitivity and specificity were 57.9% and 31.2%, respectively. There were no adverse events with the procedure.
Limitation: Preliminary study.
Conclusions: This report suggests that the EchoBrush may provide adequate cellularity to diagnose solid and cystic pancreatic lesions. More extensive studies are needed to compare the EchoBrush and standard needles.