A randomized clinical trial comparing 22G and 25G needles in endoscopic ultrasound-guided fine-needle aspiration of solid lesions

Camellini, Lorenzo; Carlinfante, Gabriele; Azzolini, Francesco; Iori, Veronica; Cavina, Maurizio; Sereni, Giuliana; Decembrino, F.; Gallo, C.; Tamagnini, Ione; Valli, Riccardo; Piana, Simonetta; Campari, Cinzia; Gardini, Giorgio; Sassatelli, Romano

doi:10.1055/s-0030-1256482

Cited by 90 publications

(74 citation statements)

References 11 publications

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“…A 25-gauge needle is therefore recommended to puncture the head of the pancreas 4 . Several studies have compared the performance characteristics of a 22-gauge needle with those of a 25-gauge FNA needle for sampling pancreatic masses, but most have failed to demonstrate superiority of either needle [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] . A recent systematic review and meta-analysis of EUS-FNA for solid pancreatic masses, including a large cohort of patients, revealed that a 25-gauge needle was more sensitive than a 22-gauge needle 23 .…”

Section: Discussionmentioning

confidence: 99%

High and low negative pressure suction techniques in EUS-guided fine-needle tissue acquisition by using 25-gauge needles: a multicenter, prospective, randomized, controlled trial

Kudo

Kawakami

Hayashi

et al. 2014

Gastrointestinal Endoscopy

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Section: Discussionmentioning

confidence: 99%

High and low negative pressure suction techniques in EUS-guided fine-needle tissue acquisition by using 25-gauge needles: a multicenter, prospective, randomized, controlled trial

Kudo

Kawakami

Hayashi

et al. 2014

Gastrointestinal Endoscopy

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“…16,30,31 Although these studies showed no significant difference in diagnostic accuracy, there was a trend toward better performance with the 25-gauge needle for pancreatic head but not body or tail masses. 30,31 It is reasonably speculated that a smaller-caliber needle may reduce bleeding/hemorrhage and thereby increase cellular yield. To date, there are no studies comparing ROSE performance using 22-gauge versus 25-gauge needles.…”

Section: Factors Influencing Rosementioning

confidence: 80%

Rapid On-Site Evaluation for Endoscopic Ultrasound–Guided Fine-Needle Aspiration Diagnosis of Pancreatic Lesions

Cai

Sun

Aslanian

et al. 2015

Pathology Case Reviews

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Rapid on-site evaluation (ROSE) has repeatedly been shown to improve diagnostic performance of endoscopic ultrasound-guided fineneedle aspiration of pancreatic lesions. However, the practice of providing ROSE service varies among institutions. ROSE helps to ensure adequate sampling, appropriate specimen triage, and timely patient management. In this review, we discuss the practice and clinical significance of ROSE, the factors influencing the ROSE diagnosis, the financial considerations for providing ROSE service, and pitfalls to render a ROSE diagnosis.A 22-year-old woman was found to have a pancreatic mass during workup for acute lower abdominal pain. She was referred to our institution for further evaluation. Endoscopic ultrasound (EUS) revealed a predominantly solid mass in the head of the pancreas without involvement of adjacent vasculature. Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) was performed with rapid on-site evaluation (ROSE). The Diff-Quik-stained smears were cellular and consisted of papillary and dyscohesive clusters as well as single epithelioid cells (Fig. 1). The tumor cells were uniform and had oval nuclei (Fig. 2). Based on clinical presentation and cytomorphologic features, the ROSE diagnosis was "suspicious for solid pseudopapillary neoplasm." Additional passes were performed to collect material for cell block preparation. The Papanicolaou-stained smears showed similar cytomorphologic features. The tumor cells had evenly distributed chromatin, longitudinal nuclear grooves, and small nucleoli (Fig. 3). Immunocytochemical studies were performed on the cell block sections to substantiate the diagnosis. The tumor cells were positive for vimentin (Fig. 4), CD10, and β-catenin (Fig. 5) and negative for AE1/AE3 (Fig. 6), chromogranin, and synaptophysin. The final cytological diagnosis was "consistent with solid pseudopapillary neoplasm," which was confirmed on surgical pathology.

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“…Vilmann et al (12) did not determine any difference in the diagnostic accuracy of 22 G vs. 25 G needles in the diagnosis of intra-abdominal solid masses. Likewise, in the study of Camellini et al (13), no significant difference was determined between the efficacy of 22 G and 25 G needles. The diagnostic yield of EUS-guided FNA using 19 G and 22 G aspiration needles in patients with mediastinal lesions of unknown origin was demonstrated to be similar (14).…”

Section: Which Eus Needle Is More Effective?mentioning

confidence: 89%

Endoscopic ultrasound-guided tissue sampling: How can we improve the results?

Alper

Paker²,

Arabul³

et al. 2016

Turk J Gastroenterol

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INTRODUCTIONWith endoscopic ultrasound (EUS) guidance, it is possible to obtain tissue or fluid samples from all lesions at a distance of not more than 5-6 cm, which is the distance the echoendoscope can reach. EUS enables a gastroenterologist to sample the masses of the middle and inferior mediastinum, which are adjacent to the esophagus; cystic or solid lesions of the pancreas, which are adjacent to the stomach and duodenum; perirectal lesions; subepithelial lesions of the upper gastrointestinal tract; upper abdominal masses; and lesions located in the left kidney, left adrenal gland, and left lobe of the liver by fine-needle aspiration (FNA) or core biopsy.

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A randomized clinical trial comparing 22G and 25G needles in endoscopic ultrasound-guided fine-needle aspiration of solid lesions

Abstract: Our study failed to demonstrate that the 25G is more effective than the 22G needle in EUS-FNA of solid lesions. However, targeting of lesions in the distal duodenum may be simplified by using the 25G needle.

Cited by 90 publications

References 11 publications

High and low negative pressure suction techniques in EUS-guided fine-needle tissue acquisition by using 25-gauge needles: a multicenter, prospective, randomized, controlled trial

High and low negative pressure suction techniques in EUS-guided fine-needle tissue acquisition by using 25-gauge needles: a multicenter, prospective, randomized, controlled trial

Rapid On-Site Evaluation for Endoscopic Ultrasound–Guided Fine-Needle Aspiration Diagnosis of Pancreatic Lesions

Endoscopic ultrasound-guided tissue sampling: How can we improve the results?

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