Endoscopic ultrasound-guided sampling of solid pancreatic masses: the fine needle aspiration or fine needle biopsy dilemma. Is the best needle yet to come?

Conti, Clara Benedetta; Cereatti, Fabrizio; Grassia, Roberto

doi:10.4253/wjge.v11.i8.000

Cited by 16 publications

(29 citation statements)

References 87 publications

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“…Similar results in terms of diagnostic yield and specimen adequacy for a correct diagnosis were also reported with use of 25 G needles compared to larger ones; however, despite the high diagnostic yield of 25 G needles, the smaller samples obtained with these needles could represent a limit considering advances in new oncological and molecular discoveries related to pancreatic cancer [16].…”

Section: Is Fnb Better Than Fna?supporting

confidence: 70%

Tissue acquisition and pancreatic masses: Which needle and which acquisition technique should be used?

et al. 2020

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Background and study aims Pancreatic cancer represents the fourth most common cause of cancer-related deaths in Western countries and the need of a low-risk investigation to obtain an accurate histopathological diagnosis has become increasingly pressing. Endoscopic ultrasonography (EUS) with fine-needle aspiration (FNA) is the standard method for obtaining samples from pancreatic masses. In recent years, there has been an increasing need to obtain histological specimens during EUS procedures, rather than cytological ones, to guide oncological treatment options, leading to the so-call “FNB concept.” Different needles have been developed for fine-needle biopsy (FNB) in recent years, enabling acquisition of larger specimens on which to perform histological and molecular analyses. The aim of this narrative review was to assess the role of EUS-guided FNA and FNB in patients with pancreatic masses, and to identify which needle and which acquisition technique should be used to improve tissue acquisition.

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Section: Is Fnb Better Than Fna?supporting

confidence: 70%

Tissue acquisition and pancreatic masses: Which needle and which acquisition technique should be used?

et al. 2020

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“…Core tissue sampling enables the ability to diagnose pancreatic adenocarcinoma much like FNA, but also provides the ability to differentiate among other solid pancreatic lesions. 26 Core tissue sampling can dramatically impact treatment by enabling molecular profiling which may be used for personalized medicine. Indeed, histopathologic specimens obtained from FNB yield an accurate pancreatic cancer diagnosis in over 90% of cases.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic Ultrasound-Guided Fine Needle Biopsy Needles Provide Higher Diagnostic Yield Compared to Endoscopic Ultrasound-Guided Fine Needle Aspiration Needles When Sampling Solid Pancreatic Lesions: A Meta-Analysis

et al. 2021

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Pancreatic malignancy portends poor prognosis with a dismal 5-year survival of 8%. 1 Moreover, the disease burden of pancreatic cancer continues to rise, having the second highest incidence among gastrointestinal tumors in the U.S. 2 Prompt tissue diagnosis allows for early targeted treatment, potentially improving progression-free survival. 3 The advent of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) and endoscopic ultrasound-guided fine needle biopsy (EUS-FNB) has permitted minimally invasive tissue acquisition for tissue diagnosis. Unlike FNA needles, the reverse or opposing cutting bevel design of the FNB needle allows for the biopsy of core histopathologic tissue. 4 EUS-FNA and EUS-FNB provide accurate diagnoses of solid pancreatic lesions with a reported sensitivity of 85% and 87%, respectively. 5,6 Previous studies comparing the two needles have yielded conflicting results with no clear superiority. 7-10 There has been a recent increase in randomized con

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“…In this retrospective study, we examined the diagnostic efficacy of three puncture needles (PC20, PC22, and AC22) for the first EUS-FNA/B in patients with pancreatic cancer. The PC20 and PC22 employ a core trap system, which contributes to increased tissue acquisition and preservation of the histological structure [23].…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of introducing a 20-gauge core biopsy needle with a core trap in EUS-FNA/B for diagnosing pancreatic cancer

et al. 2021

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Background Endoscopic ultrasound-guided fine-needle aspiration/biopsy (EUS-FNA/B) is a standard method for pathological diagnosis of pancreatic solid lesions. The EchoTip ProCore 20G® (PC20), a 20-gauge biopsy needle with a forward-bevel core trap, has been available in Japan since 2015. Methods We compared the efficacy of the PC20 with that of the EchoTip ProCore 22G® (PC22) and Acquire 22G® (AC22) in EUS-FNA/B for diagnosing pancreatic cancer. This retrospective study included 191 patients with pancreatic cancer who underwent EUS-FNA/B using the PC20, PC22, or AC22 at our facility from April 2013 to October 2019. We investigated the patients’ clinical characteristics and the diagnostic accuracy and safety of each needle. Results A sufficient stroke length of puncture was secured in all patients. The maximum length under EUS was shorter with the AC22 (22.1 ± 2.2 mm) than PC20 (30.6 ± 0.7 mm, p < 0.01) and PC22 (30.3 ± 0.8 mm, p < 0.01). The histological accuracy was 96.4% with the PC20 but only 58.8% with the PC22 (adjusted p (p-adj) < 0.0001) and 75.0% with the AC22 (p-adj = 0.06). The diagnostic accuracy of the combination of histology and cytology was 96.4% with the PC20, while it was 72.1% with the PC22 (p-adj < 0.0001) and 91.7% with the AC22 (p-adj > 0.99). One patient (0.9%) in the PC20 group developed mild pancreatitis, but no adverse events occurred with the other needles. Conclusions The PC20 showed better diagnostic capability than the PC22. The diagnostic efficacy was similar between the PC20 and AC22. The high histological accuracy of the PC20 could be advantageous for lesions in which histological assessment is critical.

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Endoscopic ultrasound-guided sampling of solid pancreatic masses: the fine needle aspiration or fine needle biopsy dilemma. Is the best needle yet to come?

Cited by 16 publications

References 87 publications

Tissue acquisition and pancreatic masses: Which needle and which acquisition technique should be used?

Tissue acquisition and pancreatic masses: Which needle and which acquisition technique should be used?

Endoscopic Ultrasound-Guided Fine Needle Biopsy Needles Provide Higher Diagnostic Yield Compared to Endoscopic Ultrasound-Guided Fine Needle Aspiration Needles When Sampling Solid Pancreatic Lesions: A Meta-Analysis

Effectiveness of introducing a 20-gauge core biopsy needle with a core trap in EUS-FNA/B for diagnosing pancreatic cancer

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