Impact of EUS-guided fine-needle biopsy sampling with a new core needle on the need for onsite cytopathologic assessment: a preliminary study

A meta-analysis of endoscopic ultrasound–fine-needle aspiration compared to endoscopic ultrasound–fine-needle biopsy: diagnostic yield and the value of onsite cytopathological assessment

“…After full text review of these 85 articles, 70 studies were removed, including studies not having comparative data for standard FNA needles with second generation FNB needles, review articles, and studies not evaluating any of the four main outcome measures listed in the inclusion criteria. Consequently, 15 studies 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 with 1024 patients were included in the main analysis of which four were randomized trials 19 22 23 24 and 11 were observational studies 20 21 25 26 27 28 29 30 31 32 33. The search strategy is summarized in Fig.…”

“…1. Seven studies 20 23 25 26 27 28 33 used a crossover design in which both needles were used in all patients, while eight studies 19 21 22 24 29 30 31 32 used either a standard FNA needle or a core biopsy needle in each patient. Seven studies 19 23 24 25 28 29 30 included pancreatic lesions exclusively while one study 22 included subepithelial lesions exclusively.…”

“…Rapid onsite pathology evaluation was available in all of the eight studies 19 21 25 26 28 31 32 33 conducted in the United States, whereas it was only available in one non-U.S. study 24. Two studies 32 33 used the fork-tip or SharkCore needle for FNB, while the rest of the 13 studies used the ProCore needle. Study characteristics and patient demographics are presented in Table  1 and Table  2.…”

“…The Newcastle Ottawa scale was used for appraising the quality of observational studies. Three studies 20 29 32 satisfied the criteria of high quality studies, seven 21 26 27 28 30 31 33 were of moderate quality, and one 25 was of low quality (Table  2). …”

“…A total of 12 studies 20 21 23 24 25 26 27 28 29 30 31 33 comprising 791 patients evaluated the diagnostic accuracy of FNB in comparison to FNA. Pooled RR with 95 %CI for diagnostic accuracy was 0.99 (0.95, 1.03), (Cochran Q test P  = 0.18, I 2  = 27 %; Fig.…”