Comparison of Histological Sample Volumes among Various Endoscopic Ultrasound-Guided Biopsy Needles

Abstract

Endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) enables easy and accurate pathological assessment. Here, we compared and assessed the area of samples on glass slides for three needle types: a 19-gauge Franseen needle (Acquire, Boston Scientific, Natick, MA, USA), a 22-gauge Franseen needle, and a 19-gauge fine-needle aspiration (FNA) needle (EZ Shot 3 Plus; Olympus, Tokyo, Japan). Among patients with suspected pancreatic cancer, with a ≥20 mm tumor located in the pancreatic body and tail, and who underwent EUS-FNA or FNB between June 2018 and March 2020, 10 were randomly selected to test each needle. The areas of histological tissue and blood clot samples were measured using the BZ-X800 imaging software (Keyence Corporation, Osaka, Japan). Baseline patient characteristics and pathological sample data showed no significant differences among the needles. The 19-gauge Franseen needle obtained significantly more histological tissue samples than the 19-gauge conventional needle (p = 0.010) and 22-gauge Franseen needle (p = 0.008). Conversely, there was no significant difference between the 19-gauge conventional needle and 22-gauge Franseen needle (p = 0.838) in this regard. The 19-gauge Franseen needle could collect more samples than the other needles, contributing to giving a more precise pathological diagnosis and more information, including genomic profiling.

Randomized trial comparing 15 vs 5 actuations per pass during endoscopic ultrasound‐guided fine‐needle biopsy for specimen acquisition of solid pancreatic lesions

“…It has been reported that 19-G Franseen needles can increase the area by approximately three times compared to 22-G needles. 34 There were several limitations in the present study. First, this study had a crossover design, and the endosonographer was not blinded, which could have resulted in operator-related bias.…”

Comparison of the novel Franseen needle versus the fine‐needle aspiration needle in endoscopic ultrasound‐guided tissue acquisition for cancer gene panel testing: A propensity score‐matching analysis

“…The recently developed FNB needles could improve the quality and quantity of samples, for example, by using returned side holes or specifically processed tips 21 . Acquire (Boston Scientific Co., Natick, MA, USA), a Franseen‐type FNB needle, was found to collect more tissue section surface areas than the FNA needle 17,18,22 . Although Ikeda et al reported a higher rate of NOP criteria fulfillment with a 22‐G FNB needle than with a 22‐G FNA needle for EUS‐TA (11.4% vs 32.6%, P = 0.033), the results were still unsatisfactory.…”

“…21 Acquire (Boston Scientific Co., Natick, MA, USA), a Franseen-type FNB needle, was found to collect more tissue section surface areas than the FNA needle. 17,18,22 Although Ikeda et al reported a higher rate of NOP criteria fulfillment with a 22-G FNB needle than with a 22-G FNA needle for EUS-TA (11.4% vs 32.6%, P = 0.033), the results were still unsatisfactory. Furthermore, the FNB needles used were of different types rather than a single type.…”

Endoscopic ultrasound‐guided tissue acquisition for pancreatic ductal adenocarcinoma in the era of precision medicine

“…54 Takahashi et al showed superiority of a 19G Franseen needle (Acquire; Boston Scientific) compared with each of a 19G conventional needle (EZ Shot 3 Plus; Olympus, Tokyo, Japan) (P = 0.010) and a 22G Franseen needle (P = 0.008) in histological sample volumes by measuring the areas of core tissue, although the target lesions were restricted to PDAC with a tumor size of ≥20 mm, located in the body or tail of the pancreas. 58 In a recent retrospective study, Park et al evaluated the optimal approach for NGS for PDAC using EUS-FNA samples. They found a yield of only 57.4%, for the reason that the samples were collected without intention for NGS during clinical diagnostic examination, and multivariate analysis revealed a large needle size as independently associated with successful NGS.…”

“…Takahashi et al . showed superiority of a 19G Franseen needle (Acquire; Boston Scientific) compared with each of a 19G conventional needle (EZ Shot 3 Plus; Olympus, Tokyo, Japan) ( P = 0.010) and a 22G Franseen needle ( P = 0.008) in histological sample volumes by measuring the areas of core tissue, although the target lesions were restricted to PDAC with a tumor size of ≥20 mm, located in the body or tail of the pancreas 58 …”