Usefulness of a Fork-Tip Needle in Endoscopic Ultrasound-Guided Fine-Needle Biopsy for Gastric Subepithelial Lesions

Abstract

The sample adequacy and diagnostic accuracy of an endoscopic ultrasound (EUS)-guided fine-needle aspiration (EUS-FNA) for gastric subepithelial lesions (SELs) have been reported to be imperfect. To resolve these issues, a fork-tip needle as an EUS-guided fine-needle biopsy (FNB) needle has been developed. This study was conducted to evaluate the usefulness of a fork-tip needle in an EUS-FNB for gastric SELs. Seventy-nine patients who received an EUS-FNA or FNB using a fork-tip needle for gastric SELs were included in the study. The sample adequacy and diagnostic accuracy were compared between the EUS-FNB with the fork-tip needle group (fork-tip group, n = 13) and the EUS-FNA with FNA needle group (FNA group, n = 66). In addition, a multivariate analysis of the factors influencing diagnostic accuracy was conducted. Regarding sample adequacy, there was no significant difference between the groups (100% vs. 90.9%, respectively; p = 0.582). The diagnostic accuracy of the fork-tip group was numerically higher than that of the FNA group (92.3% vs. 81.8%, respectively; p = 0.682). In a multivariate analysis, the diagnostic accuracy was related to the tumor size and location of the SEL but not to the needle type. In conclusion, this study does not show statistical superiority, but suggests the useful potential of a fork-tip needle.

Efficacy and histologic frequencies of endoscopic ultrasonography‐guided tissue acquisition using conventional fine‐needle aspiration needles for gastric subepithelial hypoechoic mass

“…22 In addition, the reported accuracy of preoperative diagnosis of EUS-TA-CFNAN using 22 or 25G needles in surgically resected GSEL cases ranged from 81.8% to 96.0%. 14,15,25,26 Accuracy in this study was also high (97.3%). The reported adverse event rates were low (0-4.5%), 27 while in our series the corresponding rate was 0%.…”

“…In addition, the reported accuracy of preoperative diagnosis of EUS‐TA‐CFNAN using 22 or 25G needles in surgically resected GSEL cases ranged from 81.8% to 96.0% 14,15,25,26 . Accuracy in this study was also high (97.3%).…”

Tissue diagnosis necessary for small endoscopic ultrasound‐suspected gastric gastrointestinal stromal tumors 2 cm or less in size: A prospective study focusing on the endoscopic incisional biopsy

“…The real diagnostic yield may be even lower as the immunohistochemistry staining was available in only 40.0% and 69.3% of the FNA and FNB groups, respectively 24 . Fork‐tip FNB needles in the EUS‐guided sampling for gastric SETs with a median size of 2 cm yield a nonsignificantly higher diagnostic accuracy than conventional FNA needles 25 . However, the clinical application of these needles for a small gastric SETs 2 cm or less in size is still limited.…”

“…24 Fork-tip FNB needles in the EUS-guided sampling for gastric SETs with a median size of 2 cm yield a nonsignificantly higher diagnostic accuracy than conventional FNA needles. 25 However, the clinical application of these needles for a small gastric SETs 2 cm or less in size is still limited. For the small SETs in our study, EUS-guided needle sampling could be performed with a very short to-and-fro distance, thus seriously limiting the adequacy of the procured tissue amount.…”

Special Issue “The Next Generation of Upper Gastrointestinal Endoscopy”

“…Takasumi et al compared the sample adequacy and diagnostic accuracy of endoscopic ultrasound fine needle biopsy (EUS-FNB) using the Fork-Tip Needle with endoscopic ultrasound fine needle aspiration (EUS-FNA) for gastric subepithelial lesions (SEL) [ 11 ]. In their study, the adequate sampling rate was 100% (13/13) for EUS-FNB and 90.9% (60/66) for EUS-FNA.…”