Comparison of 20-gauge Procore® and 22-gauge Acquire® needles for EUS-FNB of solid pancreatic masses: an observational study

22G Acquire vs. 20G Procore needle for endoscopic ultrasound-guided biopsy of pancreatic masses: a randomized study comparing histologic sample quantity and diagnostic accuracy

“…Third, although we might have expected the larger needle to have yielded more tissue than the finer one, as has already been published [5,20,21], our study found that EUS-FNB performed with the 22G Acquire needle provided more than double the quantity of tissue compared with the 20G Procore needle. Our data confirm the findings of a previous pilot study [16]. The lower quantity of tissue with the 20G Procore needle could be explained by the fact that a needle with a larger diameter is more rigid, making positioning the needle in the tumor more difficult, particularly if being used for transduodenal access [16,20]; however, no puncture failures were noted with the 20G Procore needle in our study, which is in line with recently published data on the high technical success rate of EUS-FNB with the 20G Procore needle through the duodenum [22].…”

“…Our data confirm the findings of a previous pilot study [16]. The lower quantity of tissue with the 20G Procore needle could be explained by the fact that a needle with a larger diameter is more rigid, making positioning the needle in the tumor more difficult, particularly if being used for transduodenal access [16,20]; however, no puncture failures were noted with the 20G Procore needle in our study, which is in line with recently published data on the high technical success rate of EUS-FNB with the 20G Procore needle through the duodenum [22].…”

“…Better histologic and molecular characterization of the pancreatic tumor can be obtained with a histologic tissue core sample. New biopsy needles for EUS-FNB have been developed and marketed by device manufacturers but, although some data are available on the rates of core biopsy obtained by those needles [7 -9], there are very few data on the quantity of the obtained samples [14,16]. In addition, their price is roughly the same in France, with an Acquire needle costing less than 7 % more than the Procore (250 euros vs. 234 euros).…”

“…Given a previous comparative pilot study, we hypothesized a 4mm difference in the length of the tissue core biopsies obtained by the two needles [16]. The sample size was calculated with a type I error of 0.05 (two-sided) and a power of 0.9, therefore the study required a total of 60 patients.…”

“…A previous pilot observational study comparing the two needles suggested that the 22G Acquire needle was more effective than the 20G Procore needle for pancreatic tumors in terms of the quantity of the histologic sample, as evaluated by a simple, reliable, and reproducible histologic criterion, namely the cumulative length of the tissue core biopsies per needle pass [16].…”