A comprehensive review of endoscopic ultrasound core biopsy needles.

INTRODUCTION: Endoscopic ultrasound (EUS)-guided tissue acquisition by-fine needle biopsy (EUS-FNB) developed over the last two decades as an attempt to overcome the limitations of fine needle aspiration (FNA). There are now three commercially available second-generation FNB needles with different tip designs. AREAS COVERED: In this review the roles of EUS-FNA and FNB, the history and evolution of the EUS core biopsy needle are addressed followed by a presentation of currently available needles. Literature search was conducted using MEDLINE, Controlled Trials Register, US Patent Registry, Google Scholar, and Conference Abstracts. EXPERT COMMENTARY: While FNA remains the reference standard, it is limited by the inability to retain stroma and associated cellular architecture in biopsy samples. Histologic architecture is of paramount importance in providing a molecular diagnosis and for accurate tumor staging. FNB offers a superior diagnostic yield to FNA and initial experiences with the three commercially available second-generation FNB needles show highly promising results.