Title: On-site evaluation of pancreatic lessions according to Papanicolaou Society of
Pancreatobiliary Cytology, how can it contribute to diagnostic accuracy?
Version: 1 Date: 01 Apr 2022
Reviewer's report:
This is a retrospective study investigating the role of rapid on-site evaluation during EUS-guided
fine-needle aspiration of pancreatic lesions. This topic has been extensively investigated in the
literature and different meta-analysis have been published.
In your study, it seems that you included all pancreatic biopsies during a timeframe of 6 years
(2016-2021). You included 162 procedures, which means 27 EUS-FNA per year. This means
that your is not a referral center, and this seems to be the most interesting point of your study.
In fact, most data already published come from tertiary high-volume centers. In the past, it was
postulated that ROSE can be of help in low-volume centers, but data in this setting are still
lacking.
I suggest reconsidering your manuscript in this view.
Specific comments are listed here:
1) English language must be extensively revised for grammar and typos by a native English
speaker.
2) Title should be changed. I suggest: “Impact of rapid on-site evaluation on diagnostic accuracy
of EUS-guided fine-needle aspiration of solid pancreatic lesions: experience from a low-volume
center”.
3) The primary aim should be to evaluate the impact of ROSE availability on diagnostic accuracy
of EUS-FNA of solid pancreatic lesions.
4) I suggest simplifying other aims. The number of slides is not important and is obviously
associated with the number of passes. You could evaluate the number of needle passes and the
adverse events with or without ROSE.
5) Methods: Any excluding criteria? For example, what about cystic lesions or solid/cystic
lesions? I suggest excluding purely cystic lesions.
6) Change “diagnostic ability” with diagnostic yield as reported in the AGA White paper (PMID:
29074447)
7) “Fujinon Fujifilm, Tokyo, Japan, VP-4450 HD, EG 580 UT” this is not a needle type
8) It is not clear what you mean by “non-ROSE group”. Indeed, in the “Technique” paragraph
the EUS-FNA procedure in the absence of ROSE is not described. Please clarify
9) It is surprising that the number of needle passes was higher with ROSE. Indeed, one of the
known advantages of ROSE. Which were the criteria to stop the procedure in the absence of
ROSE?
10) Simplify the results when talking about the Papanicolaou classification.
Title: On-site evaluation of pancreatic lessions according to Papanicolaou Society of
Pancreatobiliary Cytology, how can it contribute to diagnostic accuracy?
Version: 1 Date: 01 Apr 2022
Reviewer's report:
This is a retrospective study investigating the role of rapid on-site evaluation during EUS-guided
fine-needle aspiration of pancreatic lesions. This topic has been extensively investigated in the
literature and different meta-analysis have been published.
In your study, it seems that you included all pancreatic biopsies during a timeframe of 6 years
(2016-2021). You included 162 procedures, which means 27 EUS-FNA per year. This means
that your is not a referral center, and this seems to be the most interesting point of your study.
In fact, most data already published come from tertiary high-volume centers. In the past, it was
postulated that ROSE can be of help in low-volume centers, but data in this setting are still
lacking.
I suggest reconsidering your manuscript in this view.
Specific comments are listed here:
1) English language must be extensively revised for grammar and typos by a native English
speaker.
2) Title should be changed. I suggest: “Impact of rapid on-site evaluation on diagnostic accuracy
of EUS-guided fine-needle aspiration of solid pancreatic lesions: experience from a low-volume
center”.
3) The primary aim should be to evaluate the impact of ROSE availability on diagnostic accuracy
of EUS-FNA of solid pancreatic lesions.
4) I suggest simplifying other aims. The number of slides is not important and is obviously
associated with the number of passes. You could evaluate the number of needle passes and the
adverse events with or without ROSE.
5) Methods: Any excluding criteria? For example, what about cystic lesions or solid/cystic
lesions? I suggest excluding purely cystic lesions.
6) Change “diagnostic ability” with diagnostic yield as reported in the AGA White paper (PMID:
29074447)
7) “Fujinon Fujifilm, Tokyo, Japan, VP-4450 HD, EG 580 UT” this is not a needle type
8) It is not clear what you mean by “non-ROSE group”. Indeed, in the “Technique” paragraph
the EUS-FNA procedure in the absence of ROSE is not described. Please clarify
9) It is surprising that the number of needle passes was higher with ROSE. Indeed, one of the
known advantages of ROSE. Which were the criteria to stop the procedure in the absence of
ROSE?
10) Simplify the results when talking about the Papanicolaou classification.
Please review this paper.
user
Title: On-site evaluation of pancreatic lessions according to Papanicolaou Society of
Pancreatobiliary Cytology, how can it contribute to diagnostic accuracy?
Version: 1 Date: 01 Apr 2022
Reviewer's report:
This is a retrospective study investigating the role of rapid on-site evaluation during EUS-guided
fine-needle aspiration of pancreatic lesions. This topic has been extensively investigated in the
literature and different meta-analysis have been published.
In your study, it seems that you included all pancreatic biopsies during a timeframe of 6 years
(2016-2021). You included 162 procedures, which means 27 EUS-FNA per year. This means
that your is not a referral center, and this seems to be the most interesting point of your study.
In fact, most data already published come from tertiary high-volume centers. In the past, it was
postulated that ROSE can be of help in low-volume centers, but data in this setting are still
lacking.
I suggest reconsidering your manuscript in this view.
Specific comments are listed here:
1) English language must be extensively revised for grammar and typos by a native English
speaker.
2) Title should be changed. I suggest: “Impact of rapid on-site evaluation on diagnostic accuracy
of EUS-guided fine-needle aspiration of solid pancreatic lesions: experience from a low-volume
center”.
3) The primary aim should be to evaluate the impact of ROSE availability on diagnostic accuracy
of EUS-FNA of solid pancreatic lesions.
4) I suggest simplifying other aims. The number of slides is not important and is obviously
associated with the number of passes. You could evaluate the number of needle passes and the
adverse events with or without ROSE.
5) Methods: Any excluding criteria? For example, what about cystic lesions or solid/cystic
lesions? I suggest excluding purely cystic lesions.
6) Change “diagnostic ability” with diagnostic yield as reported in the AGA White paper (PMID:
29074447)
7) “Fujinon Fujifilm, Tokyo, Japan, VP-4450 HD, EG 580 UT” this is not a needle type
8) It is not clear what you mean by “non-ROSE group”. Indeed, in the “Technique” paragraph
the EUS-FNA procedure in the absence of ROSE is not described. Please clarify
9) It is surprising that the number of needle passes was higher with ROSE. Indeed, one of the
known advantages of ROSE. Which were the criteria to stop the procedure in the absence of
ROSE?
10) Simplify the results when talking about the Papanicolaou classification.
assistant