Fabia Attili1, Mihai Rimbaş2, Alberto Fantin3, Carlo Fabbri4, Silvia Carrara5, Luca Di Maurizio1, Giulia Gibiino6, Alessandro Repici5, Frediano Inzani7, Antonio Gasbarrini8, Guido Costamagna9, Alberto Larghi10. 1. Digestive Endoscopy Unit, Catholic University, Rome, Italy. 2. Digestive Endoscopy Unit, Catholic University, Rome, Italy; Gastroenterology and Internal Medicine Departments, Colentina Clinical Hospital, Carol Davila University of Medicine, Bucharest, Romania. 3. Gastroenterology Unit, Department of Surgery, Oncology and Gastroenterology, University Hospital of Padua, Padua, Italy. 4. Unit of Gastroenterology and Digestive Endoscopy, AUSL Bologna Bellaria-Maggiore Hospital, Bologna, Italy. 5. Digestive Endoscopy Unit, Division of Gastroenterology, Humanitas Research Hospital, Milan, Italy. 6. Digestive Endoscopy Unit, Catholic University, Rome, Italy; Unit of Gastroenterology and Digestive Endoscopy, AUSL Bologna Bellaria-Maggiore Hospital, Bologna, Italy. 7. Department of Pathology, Catholic University, Rome, Italy. 8. Department of Internal Medicine, Gastroenterology and Hepatology, Catholic University, Rome, Italy. 9. Digestive Endoscopy Unit, Catholic University, Rome, Italy; IHU-USIAS, University of Strasbourg, Strasbourg, France. 10. Digestive Endoscopy Unit, Catholic University, Rome, Italy. Electronic address: alberto.larghi@yahoo.it.
Abstract
OBJECTIVE: Procurement of tissue core biopsy may overcome some of the limitations of EUS-FNA. We aimed at assessing the safety, core procurement yield and diagnostic accuracy of two novel available histology needles. METHODS: Data from consecutive patients with solid lesions who underwent EUS-FNB using the 25G-22G SharkCore™ needles were retrieved from 4 tertiary-care centers database. RESULTS: 146 patients (mean age 64 ± 12 years; M/F, 76/68) with 156 lesions (114 pancreatic) were identified. In 83 cases the 22G needle was used. 3.6 ± 1.2 passes per lesion were performed, without any major complications. A core biopsy was procured in 89.1% of cases. Considering malignant vs. non-malignant disease, the sensitivity, specificity, negative likelihood ratio, positive likelihood ratio, and diagnostic accuracy were 90.2% (95% CI, 83.7-94.3), 100% (95% CI, 87.2-100), 0.099 (95% CI, 0.058-0.170), 60.4 (95% CI, 3.86-947.4), and 92.3% (95% CI, 88.1-96.5). Procurement yield was significantly higher for the 22G (95.2% vs. 82.2%, p = 0.011), despite the fact that more needle passes were performed with the 25G needle (3.8 ± 1.3 vs. 3.4 ± 1.0, p = 0.028). CONCLUSIONS: EUS-FNB using the 25G-22G SharkCore™ needles is able to reach a very good procurement yield and diagnostic accuracy. The 22G-size needle showed superior core procurement and diagnostic capabilities. Large prospective studies are warranted to further evaluate the use of these types of needles.
OBJECTIVE: Procurement of tissue core biopsy may overcome some of the limitations of EUS-FNA. We aimed at assessing the safety, core procurement yield and diagnostic accuracy of two novel available histology needles. METHODS: Data from consecutive patients with solid lesions who underwent EUS-FNB using the 25G-22G SharkCore™ needles were retrieved from 4 tertiary-care centers database. RESULTS: 146 patients (mean age 64 ± 12 years; M/F, 76/68) with 156 lesions (114 pancreatic) were identified. In 83 cases the 22G needle was used. 3.6 ± 1.2 passes per lesion were performed, without any major complications. A core biopsy was procured in 89.1% of cases. Considering malignant vs. non-malignant disease, the sensitivity, specificity, negative likelihood ratio, positive likelihood ratio, and diagnostic accuracy were 90.2% (95% CI, 83.7-94.3), 100% (95% CI, 87.2-100), 0.099 (95% CI, 0.058-0.170), 60.4 (95% CI, 3.86-947.4), and 92.3% (95% CI, 88.1-96.5). Procurement yield was significantly higher for the 22G (95.2% vs. 82.2%, p = 0.011), despite the fact that more needle passes were performed with the 25G needle (3.8 ± 1.3 vs. 3.4 ± 1.0, p = 0.028). CONCLUSIONS: EUS-FNB using the 25G-22G SharkCore™ needles is able to reach a very good procurement yield and diagnostic accuracy. The 22G-size needle showed superior core procurement and diagnostic capabilities. Large prospective studies are warranted to further evaluate the use of these types of needles.
Authors: Tiing Leong Ang; James Weiquan Li; Andrew Boon Eu Kwek; Prem Harichander Thurairajah; Lai Mun Wang Journal: Endosc Ultrasound Date: 2019 Jul-Aug Impact factor: 5.628