Core needle versus standard needle for endoscopic ultrasound-guided biopsy of solid pancreatic masses: a randomized crossover study

Vanbiervliet, Geoffroy; Napoléon, Bertrand; Paul, M.C. Saint; Sakarovitch, Charlotte; Wangermez, Marc; Bichard, Philippe; Subtil, C.; Koch, Stéphane; Grandval, Philippe; Gincul, Rodica; Karsenti, David; Heyries, Laurent; Duchmann, Jean-Christophe; Bourgaux, Jean François; Levy, Michael J.; Calament, G; Fumex, Fabien; Pujol, B.; Lefort, Christine; Poincloux, Laurent; Pagenault, Maël; Bonin, Eduardo Aimé; Fabrè, Monique; Barthet, Marc

doi:10.1055/s-0034-1377559

Cited by 98 publications

(100 citation statements)

References 17 publications

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“…However, this study used suction during procurement of FNB, which may have increased the bloodiness and contamination of specimens. Two recently published prospective, randomized trials have also shown no difference in diagnostic yield between EUS-FNA and EUS-FNB for pancreas mass lesions [44,45]. Consistent with the previously published literature, results from this randomized controlled trial also showed no difference in diagnostic yield between EUS-FNA and EUS-FNB for pancreatic masses (FNB: 91.7 %, FNA: 78.4 %, P = 0.19).…”

Section: Discussionsupporting

confidence: 89%

Untitled

2016

Endosc Int Open

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Section: Discussionsupporting

confidence: 89%

Untitled

2016

Endosc Int Open

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“…A similarly low negative predictive value (64%) was found previously in a study using core biopsy and cytoblock preparation [6]. To increase this value, a higher number of passes [11], a proper selection of adequate material [6] or guidance under contrast enhancement can be performed [21].…”

Section: Discussionmentioning

confidence: 54%

“…The procurement of visible core was obtained in all cases in our [4,6,10,22]. Conversely, there is one paper showing a diagnostic rate of 34% based on core biopsy with a 22G needle and five passes [23].…”

Section: Discussionmentioning

confidence: 94%

“…A similar accuracy (82.5%) was obtained in a third study with two passes of FNA. The sample quality for histological analysis (diagnostic cell clusters, appropriate architecture) differed between two experienced endosonographers, proving the importance of the technique in core sampling [6]. Previously, a diagnosis sensitivity rate of 60-73% by using another 22G needle [10,21,22] was obtained.…”

Section: Discussionmentioning

confidence: 99%

“…Pro-core needles are also useful for obtaining histology from all parts of the pancreas (the core procurement rate is 88-100%), but they have a higher cost than the standard 22G needles [3,4]. For the 22G core-needles the histologic core is obtained in 76-88% of cases [3][4][5][6], but for the 25G needles only in 32% of the patients [7]. However, their results seem similar to the core biopsy obtained with the standard fine needle aspiration (FNA) needle [4].…”

Section: Endoscopic Ultrasound ( E U S ) -G U I D E D B I O P S Y I Nmentioning

confidence: 99%

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Performance of the Standard 22G Needle for Endoscopic Ultrasound-guided Tissue Core Biopsy in Pancreatic Cancer

Seicean

Gheorghiu

Zaharia

et al. 2016

JGLD

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Background & Aim: Endoscopic ultrasonography (EUS) and EUS-guided fine-needle aspiration (EUS-FNA) are considered good tools for the diagnosis of pancreatic cancer and for obtaining material for cytology or histology. The accuracy of EUS-FNA can rise to 85-95%, but it is lower in cases with a chronic pancreatitis background or with previous biliary stenting. We aimed to establish the diagnostic yield of the visible length of the core biopsy samples in pancreatic cancer by using one single type of standard 22G needle and to evaluate the factors which can influence the results. Method: EUS-FNA was performed by using a 22G standard needle on patients prospectively recruited with the suspicion of pancreatic masses on transabdominal ultrasound or CT scan over a period of eight months. The number of passes was limited by the length of the core obtained. The final diagnosis was based on EUS-FNA or hepatic biopsy for their metastasis or by follow up every three month by imaging methods. Results: The study included 118 patients. Previous stents were present in 10 patients and chronic pancreatitis features were found in 3 patients. The procedure sensitivity was 89% and the global accuracy was 89%. The presence of biliary stents did not impede the accuracy of results. The number of passes did not influence the results. Conclusions: The diagnostic rate of core biopsy by using 22G needles had a high accuracy and it is safe when the length of core dictates the number of passes. The presence of biliary stents did not influence the results. Abbreviations: AUC: area under the curve; EUS: endoscopic ultrasonography; EUS-FNA: fine needle aspiration under endosonographic guidance; FNA: fine needle aspiration; INR: international normalised ratio; OR: odds ratio.

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