Optimizing EUS-guided liver biopsy sampling: comprehensive assessment of needle types and tissue acquisition techniques

Schulman, Allison R.; Thompson, Christopher C.; Odze, Robert D.; Chan, Walter W.; Ryou, Marvin

doi:10.1016/j.gie.2016.07.065

Cited by 67 publications

(63 citation statements)

References 26 publications

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“…On the basis of our cohort, specimen adequacy far exceeds that of current standards, which may be due to the use of a dedicated fork-tip needle, which was recently shown to be superior to EUS FNA needles and two 18-gauge percutaneous biopsy needles in human cadaveric tissue. 5 Standards for specimen adequacy using EUS have not been established but should mirror those used for percutaneous biopsy. Length of specimen, number of CPTs, and needle-gauge type are important factors in diagnostic yield.…”

Section: Discussionmentioning

confidence: 99%

“…Length of specimen, number of CPTs, and needle-gauge type are important factors in diagnostic yield. 5 Questions remain regarding EUS-guided liver biopsy including type of needle and techniques used (eg, the use and amount of suction), sampling either left or right lobes (performed transduodenally), and minimum number of passes required to achieve adequacy. Additional evidence is needed regarding EUS-guided liver biopsy in patients with cirrhosis, ascites, PSC, and after liver transplantation.…”

Section: Discussionmentioning

confidence: 99%

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Endoscopic Ultrasound–guided Parenchymal Liver Biopsy: Single Center Experience of a New Dedicated Core Needle

Shah

Sasatomi

Baron

2017

Clinical Gastroenterology and Hepatology

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Endoscopic Ultrasound–guided Parenchymal Liver Biopsy: Single Center Experience of a New Dedicated Core Needle

Shah

Sasatomi

Baron

2017

Clinical Gastroenterology and Hepatology

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“…Endoscopic ultrasonography (EUS) has become an indispensable diagnostic method in gastroenterology and new indications for EUS continue to emerge [1]. There has been a sustained progress in EUS diagnostic, potential due to constantly improving imaging systems and needles, which resulted in better tissue acquisition and lower technical failure rate [2][3][4][5][6][7]. Ultrasonography (US) or computed tomography (CT) guided liver biopsy are frequently used for the diagnosis of focal liver lesions.…”

Section: Introductionmentioning

confidence: 99%

Accuracy of endoscopic ultrasound-guided biopsy of focal liver lesions

et al. 2020

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Aim: Endoscopic ultrasound (EUS) has become an indispensable method for diagnosis in gastroenterology and new indications for EUS continue to emerge. However, there are limited data regarding the accuracy of EUS-guided biopsy of hepatic focal lesions. The aim of this study was to assess the diagnostic yield of EUS-guided fine needle aspiration (FNA) of focal liver lesions.Material and methods: We conducted a prospective study in which patients with focal liver lesions, detected by transabdominal ultrasound and computed tomography or magnetic resonance imaging, underwent EUS-guided FNA to determine the diagnostic yield of the procedure.Results: In 47/48 of patients, the results of EUS-FNA were positive for malignancy, while in one case the acquired fragment was insufficient for appropriate histological analysis. Diagnostic yield was 0.98. In 83% of the cases biopsies were taken from the left lobe and in 17% from the right lobe with the same technical success rate. The most common diagnosis was metastatic adenocarcinoma of the pancreas (26% cases) followed by cholangiocarcinoma (17% cases). Concurrent sampling of other sites in addition to the liver and/or primary tumor was realized in 35% of the cases, with results that correlated with the liver biopsy and with the primary tumor biopsy. We reported no immediate or long-term complications in any of the patients.Conclusions: EUS guided fine needle aspiration/biopsy of focal liver lesions is safe, provides a very high diagnostic accuracy and should not be considered only as a rescue method after failure of percutaneous guided biopsies.

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“…The technique of EUS-LB has evolved. The first core needle used to obtain core biopsy specimen was the Quick-Core (Cook Medical Inc, Bloomington, Indiana, United States) by means of a spring-loaded trucut mechanism [16]. We recently published an article on use of 19-gauge needles in obtaining parenchymal cores with a modified one-pass, one actuation wet suction technique.…”

Section: Discussionmentioning

confidence: 99%

EUS-guided fine-needle core liver biopsy with a modified one-pass, one-actuation wet suction technique comparing two types of EUS core needles

et al. 2020

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Background and study aims We compared the diagnostic yield and specimen adequacy in EUS-guided parenchymal biopsies between two types of EUS 19 G core needles. Patients and methods This is a retrospective study of 420 patients at two tertiary medical centers in Florida with unexplained abnormal liver associated tests were referred for EUS evaluation of biliary obstruction and pancreatic pathology. EUS-guided liver biopsy (EUS-LB) was performed at the same session after biliary obstruction was excluded. We compared intact specimen length (ISL), total specimen length (TSL), complete portal triads (CPT) and adverse events (AE). Welch’s T and Tukey tests were used for ISL, TSL and CPT. Results A total of 210 patients underwent EUS-LB using a Franseen needle, 210 patients using a fork-tip needle. Median patient age was 52 years (15.63) and 238 (56.7 %) were female. The fork-tip needle had a mean ISL of 2.7 (1.1 SD) cm, TSL of 6 cm (2.1 SD), and mean 19.5 CPT (8.5 SD) Abdominal pain occurred in 35 patients (17 %) post-procedure and was managed with supportive care. Two patients required intravenous (IV) narcotic administration. Subcapsular hematomas occurred in 1 (0.5 %) patients. The Franseen needle had a mean ISL of 3.1 cm (1.3 SD), TSL of 6.5 cm (2.6 SD), and mean of 24 CPT (8.8 SD). Abdominal pain occurred in four patients (2 %) post-procedure, which resolved in all patients after IV narcotic administration. Subcapsular hematomas occurred in 1 (0.5 %) and bile leak in 1(0.4 %) patients. Conclusions Use of the Franseen needle resulted in better liver core samples than that obtained with a fork-tip needle.

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Optimizing EUS-guided liver biopsy sampling: comprehensive assessment of needle types and tissue acquisition techniques

Cited by 67 publications

References 26 publications

Endoscopic Ultrasound–guided Parenchymal Liver Biopsy: Single Center Experience of a New Dedicated Core Needle

Endoscopic Ultrasound–guided Parenchymal Liver Biopsy: Single Center Experience of a New Dedicated Core Needle

Accuracy of endoscopic ultrasound-guided biopsy of focal liver lesions

EUS-guided fine-needle core liver biopsy with a modified one-pass, one-actuation wet suction technique comparing two types of EUS core needles

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