A Comparative Study of 22G versus 19G Needles for EUS-Guided Biopsies for Parenchymal Liver Disease: Are Thinner Needles Better?

Patel, Harsh K.; Saxena, Romil; Rush, Natalia; Patel, Suchi K.; Dasari, Chandra S.; Mneimneh, Wadad; Quickery, Ariel; Rahal, Mahmoud; Temnykh, Lindsey; DeWitt, John M.; Al‐Haddad, Mohammad

doi:10.1007/s10620-020-06165-x

Cited by 28 publications

(25 citation statements)

References 22 publications

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“…However, in a recent meta-analysis of studies using 19-gauge needles, tissue acquisition was better in the FNA needles compared with the core biopsy needles, with a diagnostic yield of 95.8% and adverse events rate of 0.9% [ 44 ]. The superiority of the 19-gauge FNA needle in terms of specimen adequacy compared with the 22-gauge FNB needle and two types of 19-gauge FNB needle (one true cut and the other non-true cut) was also shown in a very recent study by Patel et al [ 45 ]. A meta-analysis by Khan et al summarized that cytological assessment of material obtained by FNA is proven to be sufficient; however, in cases needing tissue architecture examination, immunohistochemical staining, and molecular analysis, FNB is preferred to allow tissue acquisition for histologic examination [ 46 ].…”

Section: Eus-guided Liver Biopsymentioning

confidence: 70%

A State-of-the-Art Review on the Evolving Utility of Endoscopic Ultrasound in Liver Diseases Diagnosis

et al. 2020

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Liver diseases are amongst the most common diseases worldwide and manifest as a parenchymatic and/or biliary injury due to several causes as well as focal liver lesions, ranging from benign to malignant ones. The diagnosis of liver diseases is based mainly on biochemical and advanced imaging studies and, when required, on liver biopsy. Endoscopic ultrasound (EUS), which combines endoscopy and ultrasonography, is one of the main examination techniques used in gastroenterology as it is applied to evaluate abnormalities in the lumen of the upper and lower gastrointestinal tract and to define pancreatic and hepato-biliary features, often in chronic patients. Given its high spatial resolution and its proximity to the liver, EUS is gaining popularity in the diagnostic work up of liver diseases. This is a comprehensive overview of the current literature on the diagnostic indications for EUS use in patients with liver diseases. We performed a MEDLINE\PubMed and Embase search, and all articles that were relevant, after reviewing abstracts, were assessed and the full text was analyzed to extract data regarding technical success, diagnostic yield, bioptic characteristics, and complications rate. EUS-guided imaging and biopsy techniques in liver diseases have shown consistent favorable promising results among the reports through the literature, with an excellent diagnostic yield and safety profile, especially in the context of focal lesions and portal hypertension. The application of EUS in the diagnosis of liver diseases is a promising technique and should be considered as a first-line therapeutic option in selected cases.

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Section: Eus-guided Liver Biopsymentioning

confidence: 70%

A State-of-the-Art Review on the Evolving Utility of Endoscopic Ultrasound in Liver Diseases Diagnosis

et al. 2020

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“…In the case of diffuse liver disease, a meta-analysis comprising seven studies proved that the length of the specimen when EUS-FNB was used was similar to the percutaneous result [ 22 ]. Additionally, 19G FNA needles are preferred over 22G FNB needles due to fragmentation during sample processing, which was interpreted due to specimen friability related to its size [ 8 , 23 ]. Other studies proved that in diffuse liver disease, 19G FNB needles are superior to 19G FNA needles [ 7 ] or 22G FNB needles [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

Endoscopic Ultrasound-Guided Fine-Needle Biopsy versus Fine-Needle Aspiration in the Diagnosis of Focal Liver Lesions: Prospective Head-to-Head Comparison

et al. 2022

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Endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) or fine-needle aspiration (EUS-FNA) from focal liver lesions are indicated in selected cases, but there has been no previous comparison of needle types of the same size. The aim of our study was to compare the histologic diagnostic accuracy and adequacy of cores obtained with EUS-FNB needles in contrast to those obtained with FNA needles in focal liver lesions. This prospective one-center study included patients with left lobe hepatic focal lesions with contraindications for percutaneous liver biopsy or need for EUS for concomitant lesions. Each patient had one pass of 22G EUS-FNB (Franseen) needle and one pass of 22G EUS-FNA in a crossover manner, without macroscopic on-site evaluation. Each sample was analyzed separately for histologic adequacy and diagnosis. The final diagnosis was based on histology results or on imaging follow-up in the case of negative biopsies. The EUS-FNB samples (n = 30) were found to be more adequate for histologic analysis, with more cellularity and longer tissue aggregates than the EUS-FNA samples (n = 30). The accuracy of EUS-FNB was 100%, whereas that of EUS-FNA was 86.7% (p = 0.039). No post-procedure complications were noted. The 22G EUS-FNB needle proved superior to 22G EUS-FNA in terms of tissue acquisition diagnostic accuracy and histologic adequacy in focal liver lesions.

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“…A metaanalysis involving 23 studies, involving 1326 subjects revealed that EUS core biopsy needles had more chances of providing a complete core as compared to fine needle aspiration needles [9]. Another study showed how inadequate sample when using the 22 gauge franseen tip needle when compared to the 19 gauge needle [10].…”

Section: Discussionmentioning

confidence: 99%

Endoscopic Ultrasound-Guided Liver Lesions Biopsy with Atypical Malignancies- An Alternative to Radiological Biopsy

Majid

Urrehman

Khan

et al. 2022

JPRI

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Background: Endoscopic ultrasound (EUS) is gaining attraction as an alternative method of obtaining biopsies. It offers a more targeted approach for focal lesions in liver especially for those areas which are accessible via EUS-guided method. Materials and Methods: A total of 8 patients underwent EUS-guided liver lesions biopsies (LLB). EUS Guided LLB was performed using the 22G FNA needle, 2 passes were done with slow pull technique over one minute with 10–15 strokes done in each pass to obtained core samples. The average duration of the procedures ranged from 15–30 minutes. Results: Out of 8 patients, majority were males. Most of these patients had presented with nonspecific signs and symptoms including weight loss, abdominal pain, jaundice etc. All of the 8 patients had an atypical liver lesions on initial radiological evaluation with inconclusive tumour markers and atypical CT radiological findings. Screening for Hepatitis B and C virus were negative in all of them. EUS guided biopsy performed in them revealed the following diagnosis: well differentiated adenocarcinoma, sarcomatoid carcinoma, neuroendocrine tumour, smooth muscle tumour, metastatic adenocarcinoma, lymphoproliferative disorder and malignant melanoma. Conclusions: EUS-guided LLB is an alternative new technique for biopsy of liver lesions with suspected atypical malignancies.

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A Comparative Study of 22G versus 19G Needles for EUS-Guided Biopsies for Parenchymal Liver Disease: Are Thinner Needles Better?

Cited by 28 publications

References 22 publications

A State-of-the-Art Review on the Evolving Utility of Endoscopic Ultrasound in Liver Diseases Diagnosis

A State-of-the-Art Review on the Evolving Utility of Endoscopic Ultrasound in Liver Diseases Diagnosis

Endoscopic Ultrasound-Guided Fine-Needle Biopsy versus Fine-Needle Aspiration in the Diagnosis of Focal Liver Lesions: Prospective Head-to-Head Comparison

Endoscopic Ultrasound-Guided Liver Lesions Biopsy with Atypical Malignancies- An Alternative to Radiological Biopsy

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