EUS-FNA vs EUS-FNB for Pancreatic Lesions: Which Needle When to Use?

Kovačević, Bojan; Karstensen, John Gásdal; Vilmann, Peter

doi:10.1007/s11938-021-00340-3

Cited by 4 publications

(4 citation statements)

References 77 publications

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“…Many advances in EUS-guided tissue acquisition have been made, including several novel needle designs. Tissue core needles have been shown to procure more histologygrade tissue than the regular FNA needles and maybe a suitable choice in the case of solid pancreatic lesions, especially in the era of molecular profiling and precision medicine (Kovacevic et al, 2021).…”

Section: Discussionmentioning

confidence: 99%

A Comparative Study of the Diagnostic Utility of Endoscopic Ultrasound-Guided Fine Needle Aspiration Cytology (EUS-FNA) versus Endoscopic Ultrasound-Guided Fine Needle Biopsy (EUS-FNB) in Pancreatic and Non-Pancreatic Lesions

Yousri

Abusinna

Tahoun

et al. 2022

Asian Pac J Cancer Prev

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Objectives: Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) has become the procedure of choice to obtain samples from pancreatic lesions. However, it still has limitations affecting its diagnostic yield. The endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) needle was developed to allow acquisition of histological core. We conducted this study to compare the diagnostic yield of the Echotip 22Gauge FNA needle with the 22Gauge acquire FNB needle in pancreatic and non-pancreatic lesions. Materials and Methods: This prospective study was carried out on 100 cases of pancreatic and non-pancreatic lesions referred to El-Ebrashi unit of Gastroenterology and Hepatology, internal medicine department, Kasr Al-Aini hospital. The patients included were then randomized for sampling using either the standard Echotip 22Gauge FNA needle or 22Gauge acquire FNB needle. Results: Patients were 57 males and 43 females with a mean age of 58±15 years. Seventy-eight patients had pancreatic lesions, while twenty-two patients had non-pancreatic lesions. Half of the patients (50 cases) underwent EUS-FNA, and the other half (50 cases) underwent EUS-FNB. The presence of adequate tissue core was significantly higher in the FNB group. In contrast, smear cellularity was not significantly different between both groups. FNB had more sensitivity and accuracy depending on cell block/ tissue core examination only for diagnosing pancreatic lesions. Blood contamination was higher in cell blocks of the FNA group. The sensitivity, specificity, and accuracy in the combined cytologic and histologic evaluation were 100%. Based on smear only or tissue only, the specificity was 100%, but the sensitivity and accuracy were decreased in both techniques. No complications were reported in both techniques. Conclusion: EUS-guided FNA and FNB are safe with comparable diagnostic accuracy in pancreatic and non-pancreatic lesions. FNB improved the histopathological quality of specimens with little blood contamination. Depending on tissue examination only in diagnosing pancreatic lesions, FNB had more sensitivity and diagnostic accuracy.

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Section: Discussionmentioning

confidence: 99%

A Comparative Study of the Diagnostic Utility of Endoscopic Ultrasound-Guided Fine Needle Aspiration Cytology (EUS-FNA) versus Endoscopic Ultrasound-Guided Fine Needle Biopsy (EUS-FNB) in Pancreatic and Non-Pancreatic Lesions

Yousri

Abusinna

Tahoun

et al. 2022

Asian Pac J Cancer Prev

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“…Several novel needle designs are achieving a significant stride in the field of EUS-TA, together with tissue core needles, and provide a more histology-grade tissue compared to the regular FNA needles owing to the higher number of their cutting edges [5].…”

Section: Fig 2 Eus-fnb Of Pancreatic Adenocarcinomamentioning

confidence: 99%

“…With the growing evidence regarding the diagnostic benefits of FNB over FNA, consensus still not definitive [5], therefore, the aim of this study is to compare the diagnostic performance of EUS-FNA and EUS-FNB in solid pancreatic and non-pancreatic lesions, focusing on one needle size: 22-gauge needles.…”

Section: Introductionmentioning

confidence: 99%

Comparative diagnostic performance of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) versus endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) for tissue sampling of solid pancreatic and non-pancreatic lesions without ROSE: a prospective multicenter study

Okasha,

Ahmed,

Ahmed

et al. 2024

Egypt J Intern Med

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Background and aims Endoscopic ultrasound-guided tissue acquisition, including both fine-needle aspiration (EUS-FNA) and fine-needle biopsy (EUS-FNB), has been frequently performed to acquire samples from both pancreatic and non-pancreatic lesions. Still, the impact of the diagnostic yield between FNA and FNB is uncertain. We conducted this study to compare the diagnostic performance and accuracy of the 22-gauge FNA needles with the 22-gauge FNB needles in sampling solid pancreatic and non-pancreatic lesions. Methods This is a prospective multicenter study conducted on 465 cases presented with solid pancreatic or non-pancreatic lesions. Results Patients were 275 male and 190 females with a mean age of 59 years. Three-hundred twenty-seven patients had solid pancreatic lesions, while 138 had non-pancreatic lesions; 245 cases underwent EUS-FNA, and the remaining 211 cases underwent EUS-FNB. The presence of intact tissue core and sample adequacy was significantly higher in the FNB cases in solid pancreatic and non-pancreatic lesions. Blood contamination was significantly more in cell blocks and smears of EUS-FNA compared to that of EUS-FNB in solid pancreatic and non-pancreatic lesions. Based on histologic assessment of cell block only, EUS-FNB had more diagnostic accuracy (99%) than FNA (61%) (P-value < 0.005). However, cytological diagnosis by smears only showed no significant difference. The combined cytological and histological evaluation had 100% sensitivity, specificity, and accuracy. Conclusion EUS-FNA and EUS-FNB have comparable accuracy in diagnosing solid pancreatic and non-pancreatic lesions without ROSE. EUS-FNB is superior to EUS-FNA in acquiring intact tissue core and adequate samples with little blood contamination. Based on histological assessment (cell block/tissue core) only, EUS-FNA has less accuracy than EUS-FNB in diagnosing solid pancreatic lesions.

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“…In case of an unfavorable position of the endoscope with a sharp angulation of the tip, the more flexible 25-gauge needle can be chosen. For aspiration of cystic fluid, the 22-gauge FNA needles are the preferred ones[ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Nonsteroidal anti-inflammatory drugs before endoscopic ultrasound guided tissue acquisition to reduce the incidence of post procedural pancreatitis

de Jong,

van Delft,

Roozen

et al. 2024

World J Gastroenterol

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Endoscopic ultrasound (EUS) with fine needle aspiration or fine needle biopsy is the gold standard for sampling tissue to diagnose pancreatic cancer and autoimmune pancreatitis or to analyze cyst fluid. The most common reported adverse event of fine needle aspiration and/or fine needle biopsy is acute pancreatitis, which is likely induced by the same pathophysiological mechanisms as after endoscopic retrograde cholangiopancreatography (ERCP). According to the current European Society of Gastrointestinal Endoscopy guideline, nonsteroidal anti-inflammatory drugs are administered prior to ERCP as a scientifically proven treatment to reduce post-ERCP pancreatitis incidence rate. A single suppository of diclofenac or indomethacin prior to EUS guided tissue acquisition (TA) is harmless in healthy adults. Since it is associated with low costs and, most important, may prevent a dreadsome complication, we strongly recommend the administration of 100 mg diclofenac rectally prior to EUS-TA. We will explain this recommendation in more detail in this review as well as the risk and pathophysiology of post-EUS TA pancreatitis.

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EUS-FNA vs EUS-FNB for Pancreatic Lesions: Which Needle When to Use?

Cited by 4 publications

References 77 publications

A Comparative Study of the Diagnostic Utility of Endoscopic Ultrasound-Guided Fine Needle Aspiration Cytology (EUS-FNA) versus Endoscopic Ultrasound-Guided Fine Needle Biopsy (EUS-FNB) in Pancreatic and Non-Pancreatic Lesions

A Comparative Study of the Diagnostic Utility of Endoscopic Ultrasound-Guided Fine Needle Aspiration Cytology (EUS-FNA) versus Endoscopic Ultrasound-Guided Fine Needle Biopsy (EUS-FNB) in Pancreatic and Non-Pancreatic Lesions

Comparative diagnostic performance of endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) versus endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) for tissue sampling of solid pancreatic and non-pancreatic lesions without ROSE: a prospective multicenter study

Nonsteroidal anti-inflammatory drugs before endoscopic ultrasound guided tissue acquisition to reduce the incidence of post procedural pancreatitis

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