Comparison of EUS-guided tissue acquisition using two different 19-gauge core biopsy needles: a multicenter, prospective, randomized, and blinded study

Abstract

Background and study aims: The optimal core biopsy needle for endoscopic ultrasound (EUS) is unknown. The principle aim of this study is to compare outcomes of EUS-fine-needle biopsy (EUS-FNB) with a new 19-gauge EUS histology needle (ProCore, Cook Medical Inc., Winston-Salem, North Carolina, United States) to a conventional 19-gauge Tru-Cut biopsy (EUS-TCB) needle (19G, Quick-Core, Cook Medical Inc.). Patients and methods: Patients referred for EUS who require possible histologic biopsy were prospectively randomized to EUS-FNB or EUS-TCB. With the initial needle, ≤ 3 biopsies were obtained until either technical failure or an adequate core was obtained. Patients with suspected inadequate biopsies were crossed over to the other needle and similarly ≤ 3 passes were obtained until adequate cores or technical failure occurred. Technical success, diagnostic histology, accuracy and complication rates were evaluated. Results: Eighty-five patients (mean 58 years; 43 male) were randomized to FNB (n = 44) and TCB (n = 41) with seven patients excluded. Procedure indication, biopsy site, mass size, number of passes, puncture site, overall technical success and adverse events were similar between the two groups. FNB specimens had a higher prevalence of diagnostic histology (85 % vs. 57 %; P = 0.006), accuracy (88 % vs. 62 %; P = 0.02), mean total length (19.4 vs. 4.3 mm; P = 0.001), mean complete portal triads from liver biopsies (10.4 vs. 1.3; P = 0.0004) and required fewer crossover biopsies compared to those of TCB (2 % vs. 65 %; P = 0.0001). Overall technical success and complication rates were comparable. Conclusion: EUS-FNB using a 19-gauge FNB needle is superior to 19-gauge EUS-TCB needle.

EUS-guided fine-needle core liver biopsy with a modified one-pass, one-actuation wet suction technique comparing two types of EUS core needles

“…Comparing the 19G FNA to 22G core, the 22G had higher rates of tissue fragmentation which lead to lower tissue adequacy rates compared to 19G FNA [18]. Dewitt et al compared two 19G core needles in 85 patients and demonstrated superior ability of FNB compared to Tru-Cut biopsy needle in terms of prevalence of diagnostic histology, TSL, and CPT [20]. In a recent study by Hasan MK et al, efficacy and safety of 22-G EUS-FNB for performing EUS-MLB was evaluated.…”

Comparison between two types of needles for Endoscopic Ultrasound (EUS)‐guided fine aspiration biopsy of pancreatic and upper gastrointestinal masses

“…It was found to be superior to the Tru-cut needle in one multicenter randomized trial. 11 The Sharkcore needle (Sharkcore;…”

Susceptibility of ATM-deficient pancreatic cancer cells to radiation

“…An important question is how well these results might translate into clinical settings. ATM mutations can be detected in fine needle aspirate samples, and loss of tumoral ATM expression could be obtained in fine needle biopsies of pancreatic cancer tumor masses 36,37 and so it would be attractive to test the hypothesis that ATMmutated or otherwise ATM-deficient pancreatic cancers are more sensitive to radiotherapy than ATM-wild-type cancers and if this is the case whether or not the use of radiotherapy for local disease control should take into account the results of tumor molecular profiling. 38,39 Interestingly, we did not find any significant differences in the chemosensitivity of ATM-deficient compared to ATM-intact pancreatic cancer cells with intact ATM even for the Parp inhibitor, olaparib.…”