Randomized trial comparing the Franseen and Fork-tip needles for EUS-guided fine-needle biopsy sampling of solid pancreatic mass lesions

Bang, Ji Young; Hébert‐Magee, Shantel; Navaneethan, Udayakumar; Hasan, Muhammad; Hawes, Robert H.; Varadarajulu, Shyam

doi:10.1016/j.gie.2017.11.036

Cited by 140 publications

(165 citation statements)

References 14 publications

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“…11 Two recent randomized trials showed that the diagnostic yield on cell block exceeded 95%, and the specimen was conducive for both ancillary testing (for example, immunohistochemistry) and molecular profiling (k-ras gene mutation). 7,8 These findings are in line with the present report that included nearly 1000 patients who underwent EUS-FNB. These promising outcomes were observed in both pancreatic and non-pancreatic lesions.…”

Section: Discussionsupporting

confidence: 90%

“…Suction was not applied, and the stylet was used only for the first pass and not reinserted for subsequent passes. According to endoscopy unit policy, after establishing onsite diagnostic adequacy by ROSE, two additional dedicated passes were carried out and placed in a methanol‐based preservative (CytoLyt; Hologic Inc., Marlborough, MA, USA) for offsite assessment by cell block preparation …”

Section: Methodsmentioning

confidence: 99%

“…According to institution policy, specimens for offsite assessment were prepared as cell blocks. 7,8 For cell block preparation, a tissue pellet was constructed by first centrifuging the procured specimen, which was then mixed with plasma and thrombin, fixed in 10% formalin, and dehydrated before being embedded in paraffin. The resultant tissue block was subsequently sliced into 6-lm-thick sections and stained with hematoxylin and eosin for assessment by the cytopathologist.…”

Section: Cell Blockmentioning

confidence: 99%

“…Although randomized trials have shown that fine-needle biopsy (FNB) needles reliably procure histology-grade specimens, their impact in routine clinical practice is unclear as the knowledge of participation in a randomized trial may introduce an element of bias in specimen processing and evaluation. 7,8 The objective of the present study was to evaluate the impact of FNB on EUS-guided sampling of solid mass lesions.…”

Section: Introductionmentioning

confidence: 99%

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In memoriam: Fine‐needle aspiration, birth: Fine‐needle biopsy: The changing trend in endoscopic ultrasound‐guided tissue acquisition

Bang

Kirtane

Krall

et al. 2018

Digestive Endoscopy

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Background and Aim Fine‐needle aspiration (FNA) cytology has been the preferred technique for procuring tissue at endoscopic ultrasound (EUS) procedures for the past 25 years. To overcome some of the limitations of FNA cytology, fine‐needle biopsy (FNB) has been recently developed to yield histological tissue. Main objective was to compare the diagnostic yield of FNB compared to FNA for both onsite and offsite specimen assessment. Methods A retrospective study was conducted at a single tertiary referral center to evaluate the outcomes of FNA and FNB over a 4‐year period. EUS‐guided tissue sampling was carried out using 22‐ or 25‐G FNA needles from 2014 to 2015, and 22‐G FNB needle was used from 2016 to 2017. Results Of 3020 patients undergoing EUS‐guided sampling of solid mass lesions (pancreatic masses 71.3%, other lesions 28.7%), FNA was carried out in 68.9% and FNB in 31.1%. Median number of passes required for diagnostic adequacy on rapid onsite evaluation was significantly lower for FNB compared to FNA (1 [IQR: 1–2] vs 2 [IQR 1–3], P < 0.001). Diagnostic yield on cell block was also significantly superior with FNB compared to FNA (92.3 vs 71.1%, P < 0.001). The superior performance of FNB over FNA was observed for both pancreatic (P < 0.001) and non‐pancreatic lesions (P < 0.001). Conclusion Given these promising findings, in the future, EUS‐guided FNB will likely be the preferred technique for sampling of solid mass lesions.

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Section: Discussionsupporting

confidence: 90%

Section: Methodsmentioning

confidence: 99%

Section: Cell Blockmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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In memoriam: Fine‐needle aspiration, birth: Fine‐needle biopsy: The changing trend in endoscopic ultrasound‐guided tissue acquisition

Bang

Kirtane

Krall

et al. 2018

Digestive Endoscopy

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“…Another noteworthy result of our study was that the number of biopsy pieces in the torque group was more than in the standard group with total three passages (torque vs standard group; 5.7 ± 4.6 vs 4.9 ± 4.0) despite no significant difference between the groups. This is particularly important when differentiating several diseases requiring IHC staining because large volumes of tumor cells containing enough desmoplastic stroma contributed to a better diagnostic yield . As the new torque technique procured a larger volume of optimal tissue comparing with the standard technique, the specimen fragments were not lost or consumed during specimen processing.…”

Section: Discussionmentioning

confidence: 99%

The diagnostic performance of novel torque technique for endoscopic ultrasound‐guided tissue acquisition in solid pancreatic lesions: A prospective randomized controlled trial

Park

Lee

Song

et al. 2019

J of Gastro and Hepatol

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Background and Aim Although several techniques for improved outcomes in endoscopic ultrasound (EUS)‐guided tissue acquisition have been reported, the reported diagnostic yield for pancreatic masses is not satisfactory. The effects of novel technique (torque method) on twisting the scope in the clockwise or counterclockwise direction during EUS‐fine needle biopsy (EUS‐FNB) are unknown. We compared the diagnostic yield of EUS‐FNB for pancreatic masses using the torque and standard techniques. Methods From April 20, 2017, to March 16, 2018, 124 consecutive patients with solid pancreatic mass who underwent EUS‐FNB using either the torque or standard technique were randomly assigned. Three passes were made with each technique, comprising 10 uniform to‐and‐fro movements on each pass with a 10‐mL syringe suction. The primary outcome was procurement rates of histologic cores, and the secondary outcomes were the diagnostic performance and technical failure. Results There were significant differences between the groups regarding the procurement rate of the histologic core and optimal quality core (standard vs torque: 87.1% [54/62] vs 98.4% [61/62], P = 0.038 and 79.0% [49/62] vs 93.5% [58/62], P = 0.037). The sensitivity, specificity, positive predictive value, and negative predictive values of EUS‐FNB were 85.45%, 100%, 100%, and 46.67%, respectively, for the standard technique and 96.49%, 100%, 100%, and 71.43%, respectively, for the torque technique. The diagnostic accuracies of the standard and torque techniques were 87.10% and 96.77%, respectively. Conclusions The torque technique for EUS‐FNB offered acceptable technical feasibility and superior diagnostic performance, including optimal histologic core procurement, compared with the standard technique.

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EUS‐Guided FNA/FNB for Pancreatic Solid Lesions

Rimbaș

Rizzatti

Larghi

2021

Clinical Pancreatology for Practising Gastroenterologists and Surgeons

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Randomized trial comparing the Franseen and Fork-tip needles for EUS-guided fine-needle biopsy sampling of solid pancreatic mass lesions

Cited by 140 publications

References 14 publications

In memoriam: Fine‐needle aspiration, birth: Fine‐needle biopsy: The changing trend in endoscopic ultrasound‐guided tissue acquisition

In memoriam: Fine‐needle aspiration, birth: Fine‐needle biopsy: The changing trend in endoscopic ultrasound‐guided tissue acquisition

The diagnostic performance of novel torque technique for endoscopic ultrasound‐guided tissue acquisition in solid pancreatic lesions: A prospective randomized controlled trial

EUS‐Guided FNA/FNB for Pancreatic Solid Lesions

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