Gut and Liver Comparison of the Diagnostic Yield of the Standard 22-Gauge Needle and the New 20-Gauge Forward-Bevel Core Biopsy Needle for Endoscopic Ultrasound-Guided Tissue Acquisition from Pancreatic Lesions
Author Information
Shinya Fujie, Hirotoshi Ishiwatari, Keiko Sasaki, Junya Sato, Hiroyuki Matsubayashi, Masao Yoshida, Sayo Ito, Noboru Kawata, Kenichiro Imai, Naomi Kakushima, Kohei Takizawa, Kinichi Hotta, and Hiroyuki Ono
Division of Endoscopy, Shizuoka Cancer Center, Shizuoka, Japan

Hirotoshi Ishiwatari
Division of Endoscopy, Shizuoka Cancer Center, 1007 Shimonagakubo Nagaizumi-cho, Sunto-gun, Shizuoka 411-8777, Japan
Tel: +81-55-989-5222, Fax: +81-55-989-5551, E-mail: ishihiro481019@gmail.com
© The Korean Society of Gastroenterology, the Korean Society of Gastrointestinal Endoscopy, the Korean Society of Neurogastroenterology and Motility, Korean College of Helicobacter and Upper Gastrointestinal Research, Korean Association the Study of Intestinal Diseases, the Korean Association for the Study of the Liver, Korean Pancreatobiliary Association, and Korean Society of Gastrointestinal Cancer. All rights reserved.

Abstract
Background/Aim: To compare the diagnostic yield of a 20-gauge forward-bevel core biopsy needle (CBN) and a 22-gauge needle for endoscopic ultrasound (EUS)-guided fine needle aspiration (FNA) of a solid pancreatic mass. Methods: The use of 20-gauge CBN was prospectively evaluated for 50 patients who underwent EUS-FNA from June 2016 to December 2016. Data were compared with those obtained by a retrospective study of 50 consecutive patients who underwent EUS-FNA using standard 22-gauge needles between December 2016 and April 2017. At least two punctures were performed for each patient; the sample from the first pass was used for cytology with or without histology and that from the second pass was used for histology. Sample quantity was evaluated using the sample obtained from the second pass. Results: There was no significant difference in the diagnostic accuracy rate between the first and second passes (20-gauge CBN: 96% [48/50]; standard 22-gauge needle: 88% [44/50]). Samples >10× power fields in length were obtained from 90% (43/48) and 60% (30/50) of patients using the 20-gauge CBN and standard 22-gauge needle, respectively (p=0.01). Technical failure occurred for two patients with the 20-gauge CBN. Conclusions: Diagnostic accuracy of the 20-gauge CBN was comparable to that of the 22-gauge needle. However, two passes with the 20-gauge CBN yielded a correct diagnosis for 100% of patients when technically feasible. Moreover, the 20-gauge CBN yielded core tissue for 90% patients, which was a performance superior to that of the 22-gauge needle.
Keywords: Core biopsy needle; Diagnostic yield; Endoscopic ultrasound-guided fine needle aspiration; Biopsy, fine-needle; Pancreas
Abstract
Background/Aim: To compare the diagnostic yield of a 20-gauge forward-bevel core biopsy needle (CBN) and a 22-gauge needle for endoscopic ultrasound (EUS)-guided fine needle aspiration (FNA) of a solid pancreatic mass. Methods: The use of 20-gauge CBN was prospectively evaluated for 50 patients who underwent EUS-FNA from June 2016 to December 2016. Data were compared with those obtained by a retrospective study of 50 consecutive patients who underwent EUS-FNA using standard 22-gauge needles between December 2016 and April 2017. At least two punctures were performed for each patient; the sample from the first pass was used for cytology with or without histology and that from the second pass was used for histology. Sample quantity was evaluated using the sample obtained from the second pass. Results: There was no significant difference in the diagnostic accuracy rate between the first and second passes (20-gauge CBN: 96% [48/50]; standard 22-gauge needle: 88% [44/50]). Samples >10× power fields in length were obtained from 90% (43/48) and 60% (30/50) of patients using the 20-gauge CBN and standard 22-gauge needle, respectively (p=0.01). Technical failure occurred for two patients with the 20-gauge CBN. Conclusions: Diagnostic accuracy of the 20-gauge CBN was comparable to that of the 22-gauge needle. However, two passes with the 20-gauge CBN yielded a correct diagnosis for 100% of patients when technically feasible. Moreover, the 20-gauge CBN yielded core tissue for 90% patients, which was a performance superior to that of the 22-gauge needle.
Keywords: Core biopsy needle; Diagnostic yield; Endoscopic ultrasound-guided fine needle aspiration; Biopsy, fine-needle; Pancreas
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