Endoscopic ultrasound‐guided fine needle aspiration of pancreatic lesions with 22 versus 25 Gauge needles: A meta‐analysis

Abstract

Our meta-analysis reveals non-superiority of 25 Gauge over 22 Gauge; hence no definitive recommendations over the use of one particular device can be made.

Diagnostic accuracy of fine-needle aspiration of solid pancreatic lesions guided by endoscopic ultrasound elastography

“…The great strength of FNA is its excellent specificity (around 100% in nearly all studies), while there are still conflicting results regarding its sensitivity (which ranges from 85-93% in most trials) and sample adequacy [ 1 , 2 ]. Many technical aspects, such as needle caliber or the availability of ROSE [ 1 - 4 ], and several devices have been investigated and developed in order to improve the diagnostic performance of EUS-FNA, but none of them was proven determinant as regards reaching an optimal diagnostic accuracy.…”

“…EUS-guided FNA, although showing an excellent specificity up to 100%, has a variable sensitivity (ranging from 85% to over 93%) that depends on several factors, such as the availability of rapid on-site tissue evaluation (ROSE) by a cytopathologist, or the needle caliber [ 1 - 4 ]. This variability may lead to false-negative results, particularly in cases of pancreatic cancer occurring in patients with chronic pancreatitis.…”

Endoscopic Ultrasound-guided Specimen Collection and Evaluation Techniques Affect Diagnostic Accuracy

“…Five metaanalyses have compared the diagnostic performance of these needles; 2 suggested that 25G needles have better diagnostic sensitivity, 4,5 and 3 observed no such difference. [6][7][8] Therefore, it remains unclear whether the diagnostic performance of both 22G and 25G needles are similar or if one may be more advantageous.…”

A quarter century of EUS-FNA: Progress, milestones, and future directions

“…[ 172 173 174 175 ] One study has shown a higher accuracy for the 25-G needle;[ 169 ] the others have shown no significant difference in diagnostic accuracy. Studies comparing FNA with 25-G and 22-G needles were also subjected to four meta-analyses[ 176 177 178 179 ] that provided conflicting results. The recent meta-analysis by Facciorusso et al .,[ 176 ] comprising only randomized clinical trials, did not show significant differences between the needles in terms of sensitivity and specificity for pancreatic malignancy.…”

“…Studies comparing FNA with 25-G and 22-G needles were also subjected to four meta-analyses[ 176 177 178 179 ] that provided conflicting results. The recent meta-analysis by Facciorusso et al .,[ 176 ] comprising only randomized clinical trials, did not show significant differences between the needles in terms of sensitivity and specificity for pancreatic malignancy. On the other hand, Xu et al .…”