En
Abstract
Background and aim
Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) allows tissue acquisition from solid lesions. The endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) needle was developed to improve diagnostic yield by acquisition of histological core. The impact of the needle type (FNA or FNB) on the diagnostic yield and the technical success needs to be further studied. Therefore, the aim of our study was to compare the diagnostic accuracy and technical success of the 22-G FNA needle with the 20-G procore FNB needle in solid lesions.
Patients and methods
The study was designed as a pilot study conducted on cases with solid mediastinal, pancreatic, and intra-abdominal lesions, and the patients involved were then randomized for tissue sampling using either the standard 22-G FNA needle or the new 20-G procore FNB needle.
Results
In this six-month study, 50 patients including 29 male individuals and 21 female individuals, with a mean age of 57.1±12.3 years (range: 15–80 years) were enrolled. No significant difference was detected between FNA 22 G and FNB 20 G as regards the diagnostic accuracy or the technical success rates. However, there was a significant difference in the number of passes needed to reach diagnosis. The success rate of first pass for FNA 22 G and FNB 20 G was 69 and 92.5%, respectively (P=0.014, 95%CI).
Conclusion
EUS-guided FNA and FNB have comparable diagnostic accuracy for solid lesions. The 20-G FNB needles are easy to handle in anatomically challenging locations and required fewer needle passes to reach diagnosis.
Article PDF
Similar content being viewed by others
References
Strand DS, Jeffus SK, Sauer BG, Wang AY, Stelow EB, Shami VM. EUS-guided 22-gauge fine-needle aspiration versus core biopsy needle in the evaluation of solid pancreatic neoplasms. Diagn Cytopathol 2014; 42: 751–758.
Weston BR, Bhutani MS. Optimizing diagnostic yield for eus-guided sampling of solid pancreatic lesions: a technical review. Gastroenterol Hepatol 2013; 9: 352–363.
Ieni A, Todaro P, Crino SF, Barresi V, Tuccari G. Endoscopic ultrasound-guided fine-needle aspiration cytology in pancreaticobiliary carcinomas: diagnostic efficacy of cell-block immunocytochemistry. Hepatobiliary Pancreat Dis Int 2015; 14: 305–312.
Song TJ, Kim JH, Lee SS, Eum JB, Moon SH, Park do H et al. The prospective randomized, controlled trial of endoscopic ultrasound-guided fine-needle aspiration using 22G and 19G aspiration needles for solid pancreatic or peripancreatic masses. Am J Gastroenterol 2010; 105:1739–1745.
Mesa H, Stelow EB, Stanley MW, Mallery S, Lai R, Bardales RH. Diagnosis of nonprimary pancreatic neoplasms by endoscopic ultrasound-guided fine-needle aspiration. Diagn Cytopathol 2004; 31: 313–318.
Iglesias-Garcia J, Poley JW, Larghi A, Giovannini M, Petrone MC, Abdulkader I et al. Feasibility and yield of a new EUS histology needle: results from a multicenter, pooled, cohort study. Gastrointest Endosc 2011; 73: 1189–1196.
Dwyer J, Pantanowitz L, Ohori NP, Pai RK, Vrbin C, Brand RE, Monaco SE. Endoscopic ultrasound-guided FNA and ProCore biopsy in sampling pancreatic and intra-abdominal masses. Cancer Cytopathol 2016; 124: 110–121.
Gleeson FC, Kipp BR, Caudill JL, Clain JE, Clayton AC, Halling KC et al. False positive endoscopic ultrasound fine needle aspiration cytology: incidence and risk factors. Gut 2010; 59: 586–593.
Hawes RH. The evolution of endoscopic ultrasound: improved imaging, higher accuracy for fine needle aspiration and the reality of endoscopic ultrasound-guided interventions. Curr Opin Gastroenterol 2011; 26: 1.
Navina S, McGrath K, Chennat J, Singh V, Pal T, Zeh H et al. Adequacy assessment of endoscopic ultrasound-guided, fine-needle aspirations of pancreatic masses for theranostic studies: optimization of current practices is warranted. Arch Pathol Lab Med 2014; 138: 923–928.
Polkowski M, Larghi A, Weynand B, Boustiere C, Giovannini M, Pujol B, Dumonceau JM. Learning, techniques, and complications of endoscopic ultrasound (EUS)-guided sampling in gastroenterology: European Society of Gastrointestinal Endoscopy (ESGE) Technical Guideline. Endoscopy 2012; 44: 190–206.
Iglesias-Garcia J, Dominguez-Munoz JE, Abdulkader I, Larino-Noia J, Eugenyeva E, Lozano-Leon A, Forteza-Vila J. Influence of on-site cytopathology evaluation on the diagnostic accuracy of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) of solid pancreatic masses. Am J Gastroenterol 2011; 106: 1705–1710.
Thomas T, Kaye PV, Ragunath K, Aithal G. Efficacy, safety, and predictive factors for a positive yield of EUS-guided Trucut biopsy: a large tertiary referral center experience. Am J Gastroenterol 2009; 104: 584–591.
Larghi A, Verna EC, Ricci R, Seerden TC, Galasso D, Carnuccio A et al. EUS-guided fine needle tissue acquisition by using a 19-gauge needle in a selected patient population: a prospective study. Gastrointest Endosc 2011; 74: 504–510.
Vanbiervliet G, Napoléon B, Saint Paul MC, Sakarovitch C, Wangermez M, Bichard P et al. Core needle versus standard needle for endoscopic ultrasound-guided biopsy of solid pancreatic masses: a randomized crossover study. Endoscopy 2014; 46: 1063–1070.
Bang JY, Hawes R, Varadarajulu S. A meta-analysis comparing ProCore and standard fine-needle aspiration needles for endoscopic ultrasound-guided tissue acquisition. Endoscopy 2016; 48: 339–349.
Aadam AA, Wani S, Amick A, Shah JN, Bhat YM, Hamerski CM et al. A randomized controlled cross-over trial and cost analysis comparing endoscopic ultrasound fine needle aspiration and fine needle biopsy. Endosc Int Open 2016; 4: E497–E505.
Author information
Authors and Affiliations
Corresponding author
Additional information
This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
Rights and permissions
This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
About this article
Cite this article
Altonbary, A., Hakim, H., Bakr, D. et al. Comparison of endoscopic ultrasound-guided tissue acquisition using 22 G versus 20 G procore needles in solid lesions: a pilot study. Egypt J Intern Med 31, 266–272 (2019). https://doi.org/10.4103/ejim.ejim_118_18
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.4103/ejim.ejim_118_18