EUS-guided core biopsies of pancreatic solid masses using a new fork-tip needle: A multicenter prospective study

Leo, Milena Di; Crinò, Stefano Francesco; Bernardoni, Laura; Rahal, Daoud; Auriemma, Francesco; Correale, Loredana; Donato, Giulio Di; Massidda, Marco; Anderloni, Andrea; Manfrin, Erminia; Armellini, Elia; Poliani, Laura; Fugazza, Alessandro; Semeraro, R.; Occhipinti, Pietro; Repici, Alessandro; Carrara, Sandro

doi:10.1016/j.dld.2019.03.025

Cited by 37 publications

(20 citation statements)

References 24 publications

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“…Diagnostic adequacy was slightly superior in PC-LB group (100% vs. 94.4%), although this difference was not statistically significant ( p = 0.74), in accordance with previously published studies [ 18 , 26 ]. Our results confirmed the findings of the aforementioned trial with a greater median TSL in the PC-LB group (27.4 mm as compared to 18.5 mm in the EUS-LB group; p = 0.02).…”

Section: Discussionsupporting

confidence: 91%

Diagnostic Yield of Endoscopic Ultrasound-Guided Liver Biopsy in Comparison to Percutaneous Liver Biopsy: A Two-Center Experience

Facciorusso

Ramai

Bellocchi³

et al. 2021

Cancers

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There is scarce and conflicting evidence on the comparison between endoscopic ultrasound (EUS) and percutaneous (PC)-guided liver biopsy (LB). The aim of this study was to compare the two approaches in a series of patients with parenchymal and focal liver lesions. Fifty-four patients undergoing EUS-LB in two high-volume centers between 2017 and 2021 were compared to 62 patients who underwent PC-LB. The primary outcome was diagnostic adequacy rate. The secondary outcomes were diagnostic accuracy, total sample length (TSL), number of complete portal tracts (CPTs), procedural duration, and adverse events. Variables were compared using the Chi-square and Mann–Whitney test. Median age was 56 years (interquartile range 48–69) in the EUS-LB group and 54 years (45–67) in the PC-LB group with most patients being male. Indication for LB was due to parenchymal disease in 50% of patients, whereas the other patients underwent LB due to focal liver lesions. Diagnostic adequacy was 100% in PC-LB and 94.4% in the EUS-LB group (p = 0.74), whereas diagnostic accuracy was 88.8% in the EUS-LB group and 100% in the PC-LB group (p = 0.82). Median TSL was significantly greater in the PC-LB group (27.4 mm, IQR 21–29) when compared to the EUS-LB group (18.5 mm, 10.1–22.4; p = 0.02). The number of complete portal tracts was 21 (11–24) in the PC-LB group and 18.5 (10–23.2) in EUS-LB group (p = 0.09). EUS-LB was a significantly longer procedure (7 min, 5–11 versus 1 min, 1–3 of PC-LB; p < 0.001) and no evidence of adverse events was observed in any of the study groups. These results were confirmed in the subgroup analysis performed according to an indication for LB (parenchymal disease versus focal lesion). Although PC-LB yielded specimens with greater TSL, diagnostic adequacy and accuracy were similar between the two procedures.

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Section: Discussionsupporting

confidence: 91%

Diagnostic Yield of Endoscopic Ultrasound-Guided Liver Biopsy in Comparison to Percutaneous Liver Biopsy: A Two-Center Experience

Facciorusso

Ramai

Bellocchi³

et al. 2021

Cancers

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“…In our experience, utilization of EUS-FNB led to significant improvements in both diagnostic yield and specimen adequacy, as suggested by statistically significant differences in both parameters between FNA and FNB subgroups in patients who underwent FNA and FNB for the same lesion. Our results are comparable to recently published studies demonstrating specimen adequacies of 90.3% for a Franseen needle, 67% to 84.6% for a fork-tip needle, and 92.6% for a reverse bevel FNB needle (ProCore, Cook Medical, Bloomington, IN, United States)[ 12 , 13 , 27 , 28 ].…”

Section: Discussionsupporting

confidence: 90%

Improved diagnostic yield of endoscopic ultrasound-fine needle biopsy with histology specimen processing

Shahshahan

Hou

et al. 2020

WJGE

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BACKGROUND Endoscopic ultrasound-guided fine needle biopsy (EUS-FNB) has emerged as a safe, efficacious alternative to fine needle aspiration (FNA) for tissue acquisition. EUS-FNB is reported to have higher diagnostic yield while preserving specimen tissue architecture. However, data on the optimal method of EUS-FNB specimen processing is limited. AIM To evaluate EUS-FNB with specimen processing as histology vs EUS-FNA cytology with regards to diagnostic yield and specimen adequacy. METHODS All EUS-FNA and EUS-FNB performed at our institution from July 1, 2016, to January 31, 2018, were retrospectively analyzed. We collected data on demographics, EUS findings, pathology, clinical outcomes, and procedural complications in two periods, July 2016 through March 2017, and April 2017 through January 2018, with predominant use of FNB in the second data collection time period. FNA specimens were processed as cytology with cell block technique and reviewed by a cytopathologist; FNB specimens were fixed in formalin, processed for histopathologic analysis and immunohistochemical staining, and reviewed by an anatomic pathologist. Final diagnosis was based on surgical pathology when available, repeat biopsy or imaging, and length of clinical follow up. RESULTS One hundred six EUS-FNA and EUS-FNB procedures were performed. FNA alone was performed in 17 patients; in 56 patients, FNB alone was done; and in 33 patients, both FNA and FNB were performed. For all indications, diagnostic yield was 47.1% (8/17) in FNA alone cases, 85.7% (48/56) in FNB alone cases, and 84.8% (28/33) in cases where both FNA and FNB were performed ( P = 0.0039). Specimens were adequate for pathologic evaluation in 52.9% (9/17) of FNA alone cases, in 89.3% (50/56) of FNB alone cases, and 84.8% (28/33) in cases where FNA with FNB were performed ( P = 0.0049). Tissue could not be aspirated for cytology in 10.0% (5/50) of cases where FNA was done, while in 3.4% (3/89) of FNB cases, tissue could not be obtained for histology. In patients who underwent FNA with FNB, there was a statistically significant difference in both specimen adequacy ( P = 0.0455) and diagnostic yield ( P = 0.0455) between the FNA and FNB specimens (processed correspondingly as cytology or histology). CONCLUSION EUS-FNB has a higher diagnostic yield and specimen adequacy than EUS-FNA. In our experience, specimen processing as histology may have contributed to the overall increased diagnostic yield of EUS-FNB.

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“…Needle size did not affect pathologic diagnostic yield, with both 25-G and 22-G needles delivering high yields of 86% and 89%, respectively. The 25-G fork-tip FNB needle demonstrated high diagnostic accuracy (93%) in a recent multicenter prospective study [ 60 ].…”

Section: Eus-fnbmentioning

confidence: 99%

Current Status of Needles in the Optimization of Endoscopic Ultrasound-Guided Procedures

et al. 2020

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Endoscopic ultrasound (EUS) is among the most important tools for the evaluation of gastrointestinal tumors and affected areas around the gastrointestinal tract. It enables the acquisition of material from abnormal lesions via the gastrointestinal wall for tissue confirmation via endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA). EUS-FNA has played a vital role in oncological care and has become the standard method for tissue sampling. The choice of needle type is an important factor determining tissue acquisition and has been evaluated by many researchers. New needles are introduced into the market almost every year, and opinions vary regarding proper needle selection. While there are diverse opinions but no definitive recommendations about the use of one particular device, fine-needle biopsy needles may provide detailed information on a tissue’s architecture based on greater sample yields. This permits additional analyses, including genetic sequencing and phenotyping, thereby enabling the provision of more personalized treatment plans. Furthermore, other EUS-guided procedures have been developed, including interventional EUS and through-the-needle devices. Given the continued attempts to improve the diagnostic ability and therapeutic techniques, we review in detail the available types of puncture needles to provide guidance on the selection of the appropriate needle types.

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EUS-guided core biopsies of pancreatic solid masses using a new fork-tip needle: A multicenter prospective study

Cited by 37 publications

References 24 publications

Diagnostic Yield of Endoscopic Ultrasound-Guided Liver Biopsy in Comparison to Percutaneous Liver Biopsy: A Two-Center Experience

Diagnostic Yield of Endoscopic Ultrasound-Guided Liver Biopsy in Comparison to Percutaneous Liver Biopsy: A Two-Center Experience

Improved diagnostic yield of endoscopic ultrasound-fine needle biopsy with histology specimen processing

Current Status of Needles in the Optimization of Endoscopic Ultrasound-Guided Procedures

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