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Endoscopic ultrasound(EUS)has become an essential tool for the study of pancreatic diseases.Specifically,EUS plays a pivotal role evaluating patients with a known or suspected pancreatic mass.In this setting,differential diagnosis remains a clinical challenge.EUSguided fine-needle aspiration(FNA)and fine-needle biopsy(FNB)have been proven to be safe and useful tools in this setting.EUS-guided FNA and FNB,by obtaining cytological and/or histological samples,are able to diagnose pancreatic lesions with high sensitivity and specificity.In this context,several methodological features,trying to increase the diagnostic yield of EUS-guided FNA and FNB,have been evaluated.In this review,we focus on the role of rapid on-site evaluation(ROSE).From data reported in the literature,ROSE may increase diagnostic yield of EUS-FNA specimens by10%-30%,and thus,diagnostic accuracy.However,we should point out that many recent studies have reported adequacy rates of>90%without ROSE,indicating that,perhaps,at high-volume centers,ROSE may not be indispensable to achieve excellent results.The use of ROSE can be considered important during the learning curve of EUS-FNA,and also in hospital with diagnostic accuracy rates<90%.
Endoscopic ultrasound (EUS) has become an essential tool for the study of pancreatic disease. Specically, EUS plays a pivotal role evaluating patients with with known or suspected pancreatic mass. In this setting, differential diagnosis remains a clinical challenge. EUSguided fine-needle aspiration (FNA) and fine-needle biopsy (FNB) have been proven to be safe and useful tools in this setting. EUS-guided FNA and FNB, by obtaining cytological and / or histological samples, are able to diagnose pancreatic lesions with high sensitivity and specificity.In this context, several methodological features, trying to increase the diagnostic yield of EUS-guided FNA and FNB, have been evaluated.In this review, we focus on the role of rapid on-site evaluation (ROSE) .From data reported in the literature, ROSE may increase diagnostic yield of EUS-FNA specimens by 10% -30%, and thus, diagnostic accuracy. However, we should point out that many recent studies have reported adequacy rates of> 90% without ROSE, indicating that, perhaps, at high-volume centers, ROSE may not be indispensable to achieve excellent results. The use of ROSE can be considered important during the learning curve of EUS-FNA, and also in hospital with diagnostic accuracy rates <90%.