{
  "abstract": "Background: Endoscopic ultrasound-guided tissue acquisition (EUS-TA) is central to the pathological diagnosis of solid pancreatic masses, but the comparative value of rapid on-site cytologic evaluation (ROSE), macroscopic on-site evaluation (MOSE), and no on-site evaluation (NONE) may vary by needle type and remains uncertain.\n\nMethods: We performed a PRISMA-DTA systematic review registered in PROSPERO (CRD420251241446). Potential cohort overlap and data dependency were assessed before quantitative synthesis. Diagnostic 2 × 2 data were synthesized with a bivariate binomial-normal random-effects model. Independent direct comparisons were pooled by random-effects meta-analysis for correct versus incorrect diagnosis, with complementary absolute differences in sensitivity and specificity. An exploratory three-node network meta-analysis (NMA) compared ROSE, MOSE, and NONE.\n\nResults: Thirty-one eligible reports contributed 67 strategy-specific diagnostic datasets. After excluding 21 duplicate, nested, paired, or otherwise dependent datasets, 46 independent datasets representing 4,901 arm-level observations were included in the primary DTA. Pooled sensitivity was 0.94 (95% CI 0.92–0.95) and specificity was 1.00 (0.98–1.00); Deeks’ asymmetry test was positive (P <0.001). In direct comparisons, ROSE improved composite diagnostic accuracy versus NONE in FNA studies (OR 5.56, 95% CI 1.76–17.62; k = 4), but not in FNB studies (OR 1.08, 0.42–2.79; k = 4); the FNA-versus-FNB interaction was exploratory (P = 0.012). MOSE versus NONE in FNB was uncertain (OR 1.31, 0.60–2.87; k = 4), as was MOSE versus ROSE (OR 1.53, 0.05–49.13; k = 3). The exploratory NMA did not identify a statistically clear difference for ROSE versus NONE (OR 1.67, 0.94–2.95), MOSE versus NONE (OR 1.89, 0.86–4.20), or MOSE versus ROSE (OR 1.14, 0.48–2.71).\n\nConclusions: EUS-TA showed high overall diagnostic performance. ROSE may add value in FNA-era workflows, whereas a clear incremental benefit was not detected with FNB. MOSE remains a plausible resource-sparing strategy, but comparative estimates are imprecise. The NMA should be regarded as hypothesis-generating because of sparse comparisons, methodological heterogeneity, small-study effects, and low-to-very-low certainty.\n\nSystematic review registration: https://www.crd.york.ac.uk/PROSPERO/ , identifier CRD420251241446.",
  "abstract_shown": true,
  "affiliations": [
    "Medical Ultrasound Department, The Second Hospital of Wuhan Iron and Steel (Group) Corp",
    "Department of Thoracic and Cardiovascular Surgery, Third Hospital of Wuhan City",
    "Cancer Center, Renmin Hospital of Wuhan University"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 4,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Huifang Xu"
    },
    {
      "affs": [
        1
      ],
      "name": "Jiongming He"
    },
    {
      "affs": [
        2
      ],
      "name": "Gong Chen"
    },
    {
      "affs": [
        2
      ],
      "name": "Biao Chen"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/fay0c9dzxx9bm.bib",
  "cited_by": 0,
  "doi": "10.3389/fonc.2026.1943706",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13724458/?tool=EBI",
  "id": "fay0c9dzxx9bm",
  "issns": [
    "2234-943X"
  ],
  "landing_url": "https://www.frontiersin.org/articles/10.3389/fonc.2026.1943706/full",
  "language": "eng",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Original Research"
    ],
    [
      "openalex",
      "2730|Pancreatic and Hepatic Oncology Research"
    ]
  ],
  "openalex": "W7222983843",
  "pdf_url": "https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2026.1943706/pdf",
  "pmcid": "PMC13724458",
  "pmid": "42973725",
  "published": "2026-10-19",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/fay0c9dzxx9bm.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:13Z",
      "native_id": "10.3389/fonc.2026.1943706",
      "source": "crossref",
      "url": "https://www.frontiersin.org/articles/10.3389/fonc.2026.1943706/full"
    },
    {
      "first_seen": "2026-11-03T15:20:50Z",
      "native_id": "PMC:PMC13724458",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13724458"
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    {
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      "native_id": "PMC13724458",
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  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2730|Pancreatic and Hepatic Oncology Research",
      "subfield": "oncology"
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  ],
  "title": "Macroscopic versus rapid on-site evaluation for EUS-guided tissue acquisition of solid pancreatic masses: a systematic review, diagnostic test accuracy meta-analysis, and network meta-analysis",
  "title_text": "Macroscopic versus rapid on-site evaluation for EUS-guided tissue acquisition of solid pancreatic masses: a systematic review, diagnostic test accuracy meta-analysis, and network meta-analysis",
  "type": "peer-reviewed",
  "updated_at": "2026-11-05T12:21:12Z",
  "url": "https://research.draconitic.com/paper/fay0c9dzxx9bm",
  "venue": "Frontiers in Oncology",
  "versions": []
}