Novel ProCore 25‐gauge needle for endobronchial ultrasound‐guided transbronchial needle aspiration reduces the puncture time and frequency, with comparable diagnostic rate for mediastinal and hilar lymphadenopathy

Abstract

Background The ProCore 25‐gauge needle is a novel specifically designed puncture needle for endobronchial ultrasound‐guided transbronchial needle aspiration (EBUS‐TBNA), which may improve the puncture efficiency of the procedure while ensuring the diagnostic rate. The aim of the present study was to evaluate the diagnostic accuracy, mRNA yield, and complication rate of 25‐gauge needles compared to those of 22‐gauge needles in the evaluation of mediastinal and hilar lymphadenopathy. Methods A total of 39 patients undergoing EBUS‐TBNA at our institution were evaluated. All the procedures were performed by an experienced endoscopist formally trained in interventional pulmonology. Both the traditional 22‐gauge and ProCore 25‐gauge needles were used at each lymph node station. For all specimens obtained via EBUS‐TBNA, 50 μL was used to extract mRNA and detect the RNA concentration, whereas the other part was sent to the pathological evaluation. χ2 test and t‐test were performed to determine the differences between the two types of the needles. A P‐value of <0.05 was considered significant. Results A total of 88 lymph nodes were punctured by the two needles separately. The diagnostic accuracy for each puncture between the two needles did not show any significant difference (P > 0.05). No serious procedure‐related complications were reported. In addition, the mRNA concentration did not differ between the two types of needles (P > 0.05). Conclusion The ProCore 25‐gauge needle gained a similar diagnostic yield with less puncture time and frequency compared with the 22‐gauge needle.

Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration (EBUS-TBNA): Technical Updates and Pathological Yield

“…The ProCore ® needle from Cook Medical (Bloomington, IN, USA) is designed to provide a core of histological tissue in contrast to the cytological specimens from standard fine needle aspirations. It comes in two sizes, 22 G and 25 G. It has a reverse bevel that aims to collect a core histological sample by shearing material from the lesion during retrograde motion ( Figure 1 D) [ 24 ].…”

“…( C ) EBUS-FNB of a hilar lymph node. ( D ) ProCore ® needle with reverse bevel (image obtained with permission from John Wiley & Sons, Inc., Hoboken, NJ, USA) [ 24 ].…”

Diagnosis and staging of lung cancer with the use of one single echoendoscope in both the trachea and the esophagus: A practical guide

“…[ 37 ] A higher tissue yield was claimed for the larger needle diameter, but clinical relevance with regard to predictive biomarker analyses is still unproven. [ 38 ] Experience with core-biopsy needles designed for use with EBUS-scopes[ 39 40 41 ] and EBUS-guided intranodal forceps biopsy[ 41 ] is still limited.…”

Does needle-type increase the diagnostic yield of malignancies in endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA)?—a prospective comparative study

“…Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a commonly used minimally invasive technique. It emerged as the top-choice diagnostic procedure for benign and malignant lesions of the mediastinum and lung parenchyma (1)(2)(3)(4).…”

“…Furthermore, the EBUS-TBNA is constantly developed, and new solutions are studied to optimize the diagnostic yield. Recent papers have examined, among other things, the impact of the number of needle passes (2), use of rapid on-site evaluation (ROSE) (15) or suction syringe on the quality of specimens and a diagnostic value (16).…”