22-gauge core vs 22-gauge aspiration needle for endoscopic ultrasound-guided sampling of abdominal masses

Abstract

AIMTo compare the aspiration needle (AN) and core biopsy needle (PC) in endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) of abdominal masses.METHODSConsecutive patients referred for EUS-FNA were included in this prospective single-center trial. Each patient underwent a puncture of the lesion with both standard 22-gauge (G) AN (Echo Tip Ultra; Cook Medical, Bloomington, Indiana, United States) and the novel 22G PC (EchoTip ProCore; Cook Medical, Bloomington, Indiana, United States) in a randomized fashion; histology was attempted in the PC group only. The main study endpoint was the overall diagnostic accuracy, including the contribution of histology to the final diagnosis. Secondary outcome measures included material adequacy, number of needle passes, and complications.RESULTSFifty six consecutive patients (29 men; mean age 68 years) with pancreatic lesions (n = 38), lymphadenopathy (n = 13), submucosal tumors (n = 4), or others lesions (n = 1) underwent EUS-FNA using both of the needles in a randomized order. AN and PC reached similar overall results for diagnostic accuracy (AN: 88.9 vs PC: 96.1, P = 0.25), specimen adequacy (AN: 96.4% vs PC: 91.1%, P = 0.38), mean number of passes (AN: 1.5 vs PC: 1.7, P = 0.14), mean cellularity score (AN: 1.7 vs PC: 1.1, P = 0.058), and complications (none). A diagnosis on the basis of histology was achieved in the PC group in 36 (64.3%) patients, and in 2 of those as the sole modality. In patients with available histology the mean cellularity score was higher for AN (AN: 1.7 vs PC: 1.0, P = 0.034); no other differences were of statistical significance.CONCLUSIONBoth needles achieved high overall diagnostic yields and similar performance characteristics for cytological diagnosis; histological analysis was only possible in 2/3 of cases with the new needle.

Randomized crossover trial comparing EUS‐guided fine‐needle aspiration with EUS‐guided fine‐needle biopsy for gastric subepithelial tumors

“…To overcome these limitations associated with the aspiration needle, a new biopsy needle with reverse‐bevel technology (ProCore; Cook Endoscopy, Winston‐Salem, NC) was developed. This new core biopsy needle device was designed to obtain cytological aspirates and histological core samples simultaneously and has shown promising results for pancreatic tumors and lymph nodes . However, data on the feasibility and efficacy of EUS‐guided fine‐needle biopsy (EUS‐FNB) with this new needle device in patients with gastric SET remain limited .…”

“…This new core biopsy needle device was designed to obtain cytological aspirates and histological core samples simultaneously and has shown promising results for pancreatic tumors and lymph nodes. [5][6][7][8][9][10][11] However, data on the feasibility and efficacy of EUS-guided fine-needle biopsy (EUS-FNB) with this new needle device in patients with gastric SET remain limited. [12][13][14][15] We therefore performed a prospective, single-center, randomized controlled trial to compare the diagnostic yield of EUS-FNA with that of EUS-FNB in patients with gastric SET.…”

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

“…The PC20 and PC22 employ a core trap system, which contributes to increased tissue acquisition and preservation of the histological structure [22]. A core trap can reportedly ensure effective cellularity for diagnosis [20,23]. Acquiring tissue specimens with minimal structural damage increases the histopathological quality of the samples.…”

“…This core trap system is designed to improve the acquisition of core biopsy specimens. Sterlacci et al [20] reported that EUS tissue sampling using a 22-gauge (22G) needle with a core trap increased the accuracy of pathological diagnosis for abdominal masses compared with using a 22G aspiration needle. EchoTip ProCore® needles of various diameters are currently available.…”

Diagnostic accuracy of endoscopic ultrasound-guided fine-needle aspiration: A single-center analysis

“…After the needle had successfully entered the target puncture mass, its stylet was withdrawn and suction was applied using a 10-ml syringe. Finally, the needle was removed from the mass after suction had been released [33,34]. The number of passes depended on the endosonographer's estimation of the yielded material and ease of the operation (for this study, at least two passes were performed).…”