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 = 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

다국어 초록 (Multilingual Abstract)

Background/Aims: To compare the diagnostic yield of 20-gauge forward-bevel core biopsy needle (CBN) and 22-gauge needle for endoscopic ultrasound (EUS)-guided fine needle aspiration (FNA) of solid pancreatic masses. 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. (Gut Liver 2019;13:349-355)

참고문헌 (Reference)

1 Mayall F, "The utility of assessing the gross appearances of FNA specimens" 21 : 395-397, 2010

2 Song TJ, "The prospective randomized, controlled trial of endoscopic ultrasound-guided fine-needle aspiration using 22G and 19G aspiration needles for solid pancreatic or peripancreatic masses" 105 : 1739-1745, 2010

3 Polkowski M, "Technical aspects of endoscopic ultrasound(EUS)-guided sampling in gastroenterology : European Society of Gastrointestinal Endoscopy(ESGE)technical guideline-March 2017" 49 : 989-1006, 2017

4 Nguyen YP, "Reliability of gross visual assessment of specimen adequacy during EUS-guided FNA of pancreatic masses" 69 : 1264-1270, 2009

5 Hayashi T, "Rapid on-site evaluation by endosonographer during endoscopic ultrasound-guided fine needle aspiration for pancreatic solid masses" 28 : 656-663, 2013

6 Bang JY, "Randomized trial comparing the 22-gauge aspiration and 22-gauge biopsy needles for EUS-guided sampling of solid pancreatic mass lesions" 76 : 321-327, 2012

7 Ishiwatari H, "Randomized trial comparing a side-port needle and standard needle for EUS-guided histology of pancreatic lesions" 84 : 670-678, 2016

8 Gerke H, "Randomized study comparing endoscopic ultrasound-guided Trucut biopsy and fine needle aspiration with high suction" 21 : 44-51, 2010

9 Iwashita T, "Macroscopic on-site quality evaluation of biopsy specimens to improve the diagnostic accuracy during EUS-guided FNA using a 19-gauge needle for solid lesions : a single-center prospective pilot study(MOSE study)" 81 : 177-185, 2015

10 Dumonceau JM, "Indications, results, and clinical impact of endoscopic ultrasound(EUS)-guided sampling in gastroenterology : European Society of Gastrointestinal Endoscopy(ESGE)clinical guideline" 43 : 897-912, 2011

11 Kudo T, "High and low negative pressure suction techniques in EUS-guided fine-needle tissue acquisition by using 25-gauge needles : a multicenter, prospective, randomized, controlled trial" 80 : 1030-1037, 2014

12 Iglesias-Garcia J, "Feasibility and yield of a new EUS histology needle : results from a multicenter, pooled, cohort study" 73 : 1189-1196, 2011

13 Gleeson FC, "False positive endoscopic ultrasound fine needle aspiration cytology : incidence and risk factors" 59 : 586-593, 2010

14 Wiersema MJ, "Endosonography-guided fine-needle aspiration biopsy : diagnostic accuracy and complication assessment" 112 : 1087-1095, 1997

15 Levy MJ, "EUS-guided trucut biopsy in establishing autoimmune pancreatitis as the cause of obstructive jaundice" 61 : 467-472, 2005

16 Wani S, "EUS-guided tissue acquisition : an evidence-based approach(with videos)" 80 : 939-959.e7, 2014

17 Hewitt MJ, "EUS-guided FNA for diagnosis of solid pancreatic neoplasms : a meta-analysis" 75 : 319-331, 2012

18 Crinò SF, "Diagnostic yield of EUS-FNA of small(≤15 mm)solid pancreatic lesions using a 25-gauge needle" 17 : 70-74, 2018

19 Vanbiervliet G, "Core needle versus standard needle for endoscopic ultrasound-guided biopsy of solid pancreatic masses : a randomized crossover study" 46 : 1063-1070, 2014

20 Lee YN, "Core biopsy needle versus standard aspiration needle for endoscopic ultrasound-guided sampling of solid pancreatic masses : a randomized parallel-group study" 46 : 1056-1062, 2014

21 Petrone MC, "Comparison of pancreatic histology specimens obtained by EUS 19G versus 22G core biopsy needles : a prospective multicentre study among experienced pathologists" 5 : 854-858, 2017

22 Cotton PB, "A lexicon for endoscopic adverse events: report of an ASGE workshop" 71 : 446-454, 2010