High single-pass diagnostic yield of a new 25-gauge core biopsy needle for EUS-guided FNA biopsy in solid pancreatic lesions

Novel diagnostic and therapeutic modalities using endoscopic ultrasound in pancreatic disease

“…A retrospective review of 50 patients undergoing EUS-FNB for SPL revealed cytological sensitivity of 83% and histologic diagnostic sensitivity of 63% from a single needle pass, which increased to 96% and 86%, respectively, with additional needle passes. 45 This data is similar to 25 G EUS-FNA needles. Iwashita et al 45 also found the maneuverability of the 25 G needle for accessing the pancreatic masses in diverse sites of pancreas.…”

“…45 This data is similar to 25 G EUS-FNA needles. Iwashita et al 45 also found the maneuverability of the 25 G needle for accessing the pancreatic masses in diverse sites of pancreas. Recently, however, a new fork-tip needle, Shark Core ® (SC; Medtronic Corp., Boston, MA, USA), has been developed to improve core tissue yield with EUS with a multifaceted bevel and differing lengths of its two sharp points.…”

“…55 To overcome the challenges presented by the TCB needle, new 19 G and 22 G fine needle biopsy (FNB) needles (EchoTip ProCore; Cook Medical, Bloomington, IN, USA) were developed, featuring a reverse bevel to better obtain core tissue. 45 Bang et al 47 revealed similar performance of the 22 G EUS-FNB to EUS-FNA in a prospective cohort study of 56 patients with SPL, including number of needle passes, diagnostic yield, technical success, or complications. EUS-FNB yield of core tissue was not significantly different than EUS-FNA (83.3% vs 100%; P = 0.26).…”

“…35,[42][43][44] EUS-FNA vs EUS-FNB in solid pancreatic lesions EUS-FNA was developed in the early 1990s as a means to aid EUS imaging in the diagnosis of pancreatic lesions via tissue sampling. 6,11,45 It has since become standard of care to obtain EUS-FNA of SPL based on its cytological diagnostic sensitivity exceeding 80% in cases without underlying chronic pancreatitis. 3,6,11,46,47 Recently, a meta-analysis of 33 studies by Hewitt et al 48 revealed a sensitivity of 85% (95% CI = 0.84-0.86).…”

“…Multiple needle passes are often required to obtain an adequate sample for analysis, and the diagnostic accuracy of tissue has been found to be suboptimal without an on-site cytopathologist. 6,45,46,50 Additionally, a core tissue sample is often vital to the diagnosis of well-differentiated pancreatic adenocarcinomas and lymphomas, as their tissue morphology is necessary for precise histological evaluation. 45,47,[50][51][52] These limits led to the development of the Tru-Cut biopsy needle (TCB) compatible with EUS (Quick-Core; Wilson-Cook Medical Inc., Winston-Salem, NC, USA) (Fig.…”