Comparative accuracy of needle sizes and designs for EUS tissue sampling of solid pancreatic masses: a network meta-analysis

Equal efficacy of FNA and fine-needle biopsy needles for EUS-guided tissue acquisition: Really?

“…In the comparison of 22-gauge FNA with 25-gauge FNA needles, a total of 8 randomized trials comprising 1044 patients were included in the meta-analysis, with no significant difference in diagnostic accuracy between the 2 needle sizes. 1 The conclusion of this meta-analysis supports the results of a large randomized trial of 352 patients undergoing EUS-FNA of solid pancreatic mass lesions, which also showed that there was no significant difference in diagnostic accuracy between 22-gauge and 25-gauge FNA needles. 2 However, in the randomized trial, the use of suction with the 22-gauge FNA needle was associated with significantly increased specimen bloodiness.…”

“…Eleven randomized trials comprising 833 patients compared 22-gauge FNA with 22-gauge FNB needles, and only 1 randomized trial comprising 214 patients compared 25-gauge FNA with 25-gauge FNB needles. 1,7 The authors concluded that there was no significant difference in diagnostic accuracy between 22-gauge FNA and 22-gauge FNB needles. In addition, no significant difference was observed in diagnostic adequacy and number of passes required to establish diagnosis.…”

“…EUS-guided tissue acquisition is the current criterion standard for sampling solid pancreatic masses, and numerous studies have compared different needle sizes (19-gauge, 22-gauge, 25-gauge), needle types (FNA, fineneedle biopsy [FNB]), techniques (eg, use of suction, stylet, fanning), and the role of on-site cytopathology support. In this study by Facciorusso et al, 1 the authors conducted a thorough pairwise and network meta-analysis of randomized trials to compare the diagnostic performances of different needle sizes (19-gauge, 22-gauge, and 25-gauge) and needle types (FNA and FNB) for EUS-guided sampling of solid pancreatic masses. A total of 27 randomized trials comprising 2711 patients were included to compare primarily 2 main outcome measures: needle size (22-gauge FNA vs 25-gauge FNA) and needle type (22-gauge FNA vs 22-gauge FNB).…”

Tissue acquisition and pancreatic masses: Which needle and which acquisition technique should be used?

“…The two most important variables influencing the diagnostic accuracy of EUS-TA of pancreatic masses are the type of needle (FNA and FNB), as previously discussed, and the size (19G, 20G, 22 G or 25 G). Several types and designs of FNB needles are currently available [18] [19].…”

Diagnosing autoimmune pancreatitis: choosing your weapon

“…Can we be certain that the differences in outcomes are due to the needle head type, not the gauge? Although there have been some conflicting data, a recent meta-analysis by Facciorusso et al 9 examining different needle gauges in FNB of solid pancreatic lesions showed no difference in diagnostic yield among 19-, 22-, and 25-gauge needles. Solid pancreatic lesions, however, are a different disease process than type 1 AIP, so it is uncertain how applicable these data are to EUS-guided biopsy of the pancreas in AIP.…”