Does endoscopic ultrasound-guided fine needle biopsy using a Franseen needle really offer high diagnostic accuracy? A propensity-matched analysis

Fujita, Akashi; Ryozawa, Shomei; Mizuide, Masafumi; Araki, Ryuichiro; Nagata, Koji; Tanisaka, Yuki; Harada, Maiko; Ogawa, Tomoya; Tashima, Tomoaki; Nonaka, Kouichi

doi:10.1055/a-0957-3005

Cited by 15 publications

(20 citation statements)

References 24 publications

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“…We showed in our study a diagnostic accuracy of 85%, whereas the diagnostic accuracy for pancreatic lesions in other series was reported between 90% and 97.9%[ 5 , 11 , 14 , 16 , 18 , 19 , 24 , 26 , 28 ]. Bang et al[ 5 ] reported a significantly higher diagnostic accuracy of Franseen needle over FNA needle (97.8% vs 82.6%, P = 0.03), whereas three other series demonstrated an equal to higher diagnostic accuracy, though not significantly[ 14 , 26 , 28 ].…”

Section: Discussioncontrasting

confidence: 64%

Endoscopic ultrasound-fine needle biopsies of pancreatic lesions: Prospective study of histology quality using Franseen needle

Stathopoulos¹,

Pehl²,

Breitling³

et al. 2020

WJG

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BACKGROUND The introduction of fine needle biopsies (FNB) to clinical practice presents a changing trend towards histology in the endoscopic ultrasound-guided tissue acquisition (EUS-TA). AIM To evaluate the clinical performance of a new FNB needle, the 22-gauge (22G) Franseen needle, when sampling pancreatic solid lesions. METHODS Consecutive patients with an indication for EUS-TA for the assessment of pancreatic solid lesions were included in this prospective, single-center, single-arm trial. Each patient underwent a puncture of the lesion two times using the 22G Franseen needle and the obtained samples were directly placed into formalin for histological analysis. The primary study endpoint was the rate of high-quality obtained specimen. Secondary endpoints included the length and diameter of the core specimen, the diagnostic accuracy and the complication rate. RESULTS From June 2017 to December 2018, forty patients with pancreatic solid lesions (22 females; mean age 67.2 years) were enrolled. Tissue acquisition was achieved in all cases. High-quality histology, rated with Payne score 3, was obtained in 37/40 cases (92.5%) after two needle passes. The mean size of the acquired histological core tissue was 1.54 mm × 0.39 mm. The diagnostic accuracy for the correct diagnosis was 85% (34/40). Only one adverse event was occurred, consisting of a self-limiting bleeding in the puncture site. CONCLUSION The 22G Franseen needle achieved according to our standardized protocol a high rate of histological core procurement, and a high diagnostic accuracy, with one minor adverse event reported.

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Section: Discussioncontrasting

confidence: 64%

Endoscopic ultrasound-fine needle biopsies of pancreatic lesions: Prospective study of histology quality using Franseen needle

Stathopoulos¹,

Pehl²,

Breitling³

et al. 2020

WJG

View full text Add to dashboard Cite

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“…Furthermore, obtaining a sufficient core sample can enable genetic analysis and molecular profiling [ 8 , 14 ], which can contribute to personalized treatment selection. Several studies have already confirmed the efficacy of the Franseen needle [ 15 , 16 , 17 ]. A meta-analysis of 15 studies with 1024 patients revealed that, relative to FNA needles and in the absence of ROSE, FNB needles provided better diagnostic adequacy for solid pancreatic lesions and required fewer needle passes to establish the diagnosis [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Fine-Needle Biopsy of Small Solid Pancreatic Lesions Using a Franseen Needle during Endoscopic Ultrasound Examination

et al. 2020

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Background and aim: During endoscopic ultrasound-guided fine needle aspiration biopsy (EUS-FNB), Franseen needles can help collect sufficient tissue to permit histopathological assessment. However, its efficacy might be limited by the size of the targeted lesion. This study aimed to evaluate the feasibility of histopathological assessment of small solid pancreatic lesions using a 22-gauge Franseen needle during EUS-FNB. Methods: This retrospective study evaluated data from all patients who underwent EUS-FNB using a Franseen needle for solid pancreatic lesions at the University of Toyama Hospital between June 2018 and April 2020. Results: The study included 159 patients who had 152 malignant lesions and 7 benign lesions. The malignant lesions included pancreatic cancers (n = 134), neuroendocrine neoplasms (n = 15), metastatic tumors (n = 2), and a solid pseudopapillary neoplasm (n = 1). The diagnostic accuracy of EUS-FNB (combining histology and cytology) was 98.7%. However, the histopathological diagnosis was only confirmed for 64.3% of small lesions (<10 mm), relative to 97.2% for larger lesions. Multivariate analysis also revealed that lesion size of <10 mm predicted a less accurate histopathological diagnosis (odds ratio: 6.97, 95% confidence interval: 1.02–47.67; p = 0.041). Further analyses revealed a failed histological diagnosis in 4 patients with lesions of <5 mm in size and accurate diagnoses in 9 out of 10 patients with lesions of 5–10 mm in size. Conclusions: The diagnostic accuracy for small lesions (<10 mm), especially for lesions of <5 mm, based on histological examination alone, was significantly lower than that for others (>10 mm). Furthermore, multivariate analysis revealed that only lesion size was an independent predictor of histopathological diagnosis accuracy.

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“…Thus, considering the tip structure of the AC22, this needle might be more effective than other types particularly for cases in which a long puncture stroke length cannot be secured. Fujita et al [ 38 ] compared the diagnostic accuracy between the AC22 and a conventional needle and found no difference between the two needles for > 20-mm tumors; however, there was a significant difference for < 19-mm tumors. There was no significant difference in the histological accuracy between the PC20 and AC22 in the present study ( p = 0.02, p -adj = 0.06).…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of introducing a 20-gauge core biopsy needle with a core trap in EUS-FNA/B for diagnosing pancreatic cancer

et al. 2021

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Background Endoscopic ultrasound-guided fine-needle aspiration/biopsy (EUS-FNA/B) is a standard method for pathological diagnosis of pancreatic solid lesions. The EchoTip ProCore 20G® (PC20), a 20-gauge biopsy needle with a forward-bevel core trap, has been available in Japan since 2015. Methods We compared the efficacy of the PC20 with that of the EchoTip ProCore 22G® (PC22) and Acquire 22G® (AC22) in EUS-FNA/B for diagnosing pancreatic cancer. This retrospective study included 191 patients with pancreatic cancer who underwent EUS-FNA/B using the PC20, PC22, or AC22 at our facility from April 2013 to October 2019. We investigated the patients’ clinical characteristics and the diagnostic accuracy and safety of each needle. Results A sufficient stroke length of puncture was secured in all patients. The maximum length under EUS was shorter with the AC22 (22.1 ± 2.2 mm) than PC20 (30.6 ± 0.7 mm, p < 0.01) and PC22 (30.3 ± 0.8 mm, p < 0.01). The histological accuracy was 96.4% with the PC20 but only 58.8% with the PC22 (adjusted p (p-adj) < 0.0001) and 75.0% with the AC22 (p-adj = 0.06). The diagnostic accuracy of the combination of histology and cytology was 96.4% with the PC20, while it was 72.1% with the PC22 (p-adj < 0.0001) and 91.7% with the AC22 (p-adj > 0.99). One patient (0.9%) in the PC20 group developed mild pancreatitis, but no adverse events occurred with the other needles. Conclusions The PC20 showed better diagnostic capability than the PC22. The diagnostic efficacy was similar between the PC20 and AC22. The high histological accuracy of the PC20 could be advantageous for lesions in which histological assessment is critical.

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Does endoscopic ultrasound-guided fine needle biopsy using a Franseen needle really offer high diagnostic accuracy? A propensity-matched analysis

Cited by 15 publications

References 24 publications

Endoscopic ultrasound-fine needle biopsies of pancreatic lesions: Prospective study of histology quality using Franseen needle

Endoscopic ultrasound-fine needle biopsies of pancreatic lesions: Prospective study of histology quality using Franseen needle

Diagnostic Fine-Needle Biopsy of Small Solid Pancreatic Lesions Using a Franseen Needle during Endoscopic Ultrasound Examination

Effectiveness of introducing a 20-gauge core biopsy needle with a core trap in EUS-FNA/B for diagnosing pancreatic cancer

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