Single-pass 1-needle actuation versus single-pass 3-needle actuation technique for EUS-guided liver biopsy sampling: a randomized prospective trial (with video)

Ching-Companioni, Rafael A.; Johal, Amitpal S.; Confer, Bradley; Förster, E; Khara, Harshit S.; Diehl, David L.

doi:10.1016/j.gie.2021.03.023

Cited by 28 publications

(20 citation statements)

References 20 publications

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“…Figure 1 shows the echoendoscopic image of a needle passing through into the left hepatic lobe. In 1 pass, actuations or fanning back-and-forth motions can be done with continued suction to allow for improved tissue acquisition[ 25 ]. Multiple such passes can be done overall to increase tissue acquisition.…”

Section: Technique Of Eus-guided Liver Biopsymentioning

confidence: 99%

“…Needle pass refers to the number of times a needle is introduced into the liver parenchyma through puncture of the liver capsule, while actuation refers to the number of back-and-forth motions are made in a specified needle pass. Through our literature review, it appears the 1-pass 1-actuation technique is the most common mode of EUS-LB acquisition[ 25 , 29 ]. There are few studies that have been done comparing needle pass and needle actuation with regards to pain, adverse events, and specimen quality.…”

Section: Technique Of Eus-guided Liver Biopsymentioning

confidence: 99%

“…There are few studies that have been done comparing needle pass and needle actuation with regards to pain, adverse events, and specimen quality. A 2021 study showed that EUS-LB using a 1-pass, 3-actuation technique ( n = 40) provided longer liver cores with more CPTs than a 1-to-1 technique ( n = 40), with an equivalent safety profile: CPT (24.5 vs 17.25, P < 0.008), aggregate specimen length (12.85 cm vs 6.89 cm P < 0.001)[ 25 ].…”

Section: Technique Of Eus-guided Liver Biopsymentioning

confidence: 99%

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Update on endoscopic ultrasound-guided liver biopsy

Rangwani¹,

Ardeshna²,

Mumtaz³

et al. 2022

WJG

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Endoscopic ultrasound guided liver biopsy (EUS-LB) has emerged as a minimally-invasive alternative to the traditional (percutaneous or transjugular) liver biopsy techniques for the diagnosis of liver parenchymal diseases. Po-tentially, EUS-LB combines the advantages of percutaneous and transjugular liver biopsy in addressing focused sampling in addition to measuring portal pressure. Additionally, EUS-LB facilitates access to both the lobes of the liver which is not considered with the traditional percutaneous liver biopsy. Multiple studies have compared EUS-LB with conventional liver biopsy and reported comparable diagnostic yield, increased acquisition of complete portal tracts, and longer specimen length as compared to the traditional approaches. EUS-LB is associated with lesser post-procedural pain and shorter recovery time, while providing lower risk of complications when compared to traditional liver biopsy. Innovations in needle types, needle sizes and suction techniques have aimed at further optimizing the EUS-LB technique. This review article updates current literature with focus on the variations in the technique and equipment used for EUS-LB, and compares EUS-LB with traditional methods of liver biopsy.

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Section: Technique Of Eus-guided Liver Biopsymentioning

confidence: 99%

Section: Technique Of Eus-guided Liver Biopsymentioning

confidence: 99%

Section: Technique Of Eus-guided Liver Biopsymentioning

confidence: 99%

See 1 more Smart Citation

Update on endoscopic ultrasound-guided liver biopsy

Rangwani¹,

Ardeshna²,

Mumtaz³

et al. 2022

WJG

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show abstract

“…[ 23 ] Recent prospective RCT of 40 non-cirrhotic patients compared 1 pass, 1 actuation (1:1) with 1 pass 3 actuations with fanning (1:3) technique using 19-G FNB heparinized needle in terms of histologic yield and adequacy. Authors reported more CPTs (mean of 17.25 vs. 24.5; P <.008) and longer aggregate specimen length (6.89 cm vs. 12.85 cm; P < 0.001) with 1:3 technique[ 24 ] [ Figure 1 ]. This study also reported that at least 2 passes ideally bi-lobar are more likely to provide tissue adequacy according to the AASLD guidelines.…”

Section: Eus-guided Liver Biopsymentioning

confidence: 99%

Diagnostic and interventional EUS in hepatology: An updated review

Jearth

Sundaram

Rana

2022

Endoscopic Ultrasound

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EUS has become an increasingly used diagnostic and therapeutic modality in the armamentarium of endoscopists. With ever-expanding indications, EUS is being used in patients with liver disease, for both diagnosis and therapy. EUS is playing an important role in providing additional important information to that provided by cross-sectional imaging modalities such as computerized tomography and magnetic resonance imaging. Domains of therapy that were largely restricted to interventional radiologists have become accessible to endosonologists. From liver biopsy and sampling of liver lesions to ablative therapy for liver lesions and vascular interventions for varices, there is increased use of EUS in patients with liver disease. In this review, we discuss the various diagnostic and therapeutic applications of EUS in patients with various liver diseases.

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“…No standardized technique has yet been established for the use of EUS-FNA without on-site cytopathology; the accuracy of suction and needle actuation (to-and-fro needle movement) is debatable. [14] The European Society of Gastrointestinal Endoscopy (ESGE) recommended EUS-FNA with suction to improve sensitivity in solid lesions, even though it increases the amount of blood. A recent comparative study indicated that EUS-FNA using capillary sampling with minimal negative pressure, using a stylet slow pull technique, was associated with less blood contamination and could potentially increase the diagnostic yield of EUS-FNA for pancreatic solid masses when compared with EUS-FNA conducted with suction [15].…”

Section: Introductionmentioning

confidence: 99%

Optimal Techniques for EUS-Guided Fine-Needle Aspiration of Pancreatic Solid Masses at Facilities without On-Site Cytopathology: Results from Two Prospective Randomised Trials

Paik

Choi

Park

et al. 2021

JCM

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Background: EUS-guided fine-needle aspiration (EUS-FNA) has emerged as the primary modality for the cytologic diagnosis of pancreatic solid masses. The aim of this study is to determine whether technical factors including suction (S), non-suction (NS), capillary sampling with stylet slow-pull (CSSS), and the number of needle actuations (to-and-fro needle movements) may affect the accuracy of EUS-FNA for pancreatic solid masses at facilities without on-site cytopathology. Methods: The diagnostic yield of malignancy, blood contamination and cellularity at each sample acquired from EUS-FNA with or without S and different numbers of actuation (10, 15 and 20) were measured (study I). The optimal actuation number was determined and a head-to-head comparison trial between S and CSSS was performed (study II). Results: In study I, significant blood contamination was seen using S with 20 compared with 15 actuations (p = 0.002). Diagnostic yield of malignancy was not significantly different between 10, 15, and 20 actuations with S, whereas it was statistically higher for 15 actuations compared with 10 actuations with NS (p = 0.001). In study II, no difference was noted in diagnostic yield with 15 actuations between S and CSSS (88% vs. 90%, p = 0.74). Conclusions: Increasing actuation in NS resulted in a better diagnostic yield for EUS-FNA without significant blood contamination, whereas increasing actuation in S did not change the diagnostic yield of EUS-FNA while causing significant blood contamination. With 15 actuations, the diagnostic yield was comparable between S and CSSS.

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Single-pass 1-needle actuation versus single-pass 3-needle actuation technique for EUS-guided liver biopsy sampling: a randomized prospective trial (with video)

Cited by 28 publications

References 20 publications

Update on endoscopic ultrasound-guided liver biopsy

Update on endoscopic ultrasound-guided liver biopsy

Diagnostic and interventional EUS in hepatology: An updated review

Optimal Techniques for EUS-Guided Fine-Needle Aspiration of Pancreatic Solid Masses at Facilities without On-Site Cytopathology: Results from Two Prospective Randomised Trials

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